OECD Economic Surveys: Slovak Republic June 2017. 9789264277533, 9264277536

Table of contents :
Table of contents
Basic statistics of Slovak Republic, 2016
Executive summary
The Slovak economy has been growing strongly
Growth is strong, but will weaken because of population ageing
Inclusiveness needs to be improved
Roma employment and health status
Enhancing public-sector efficiency to raise living standards for all
Students’ education outcomes are weak and deteriorating
Assessment and recommendations
Figure 1. Slovakia is performing strongly
Figure 2. Poverty and inequality are low but some other well-being dimensions lag behind
Figure 3. Slovakia’s GDP per capita is catching up, but its population is ageing
Maintaining solid growth in living standards over the longer term will be challenging
The Slovak economy continues to expand in the short term
Figure 4. The biggest share of Slovakia’s exports is vehicles and most exports go to EU countries
Table 1. Macroeconomic indicators and projections
Box 1. Slovakia’s high reliance on the automotive industry
Figure 5. The car industry in the Slovak republic
Figure 6. Evolution of macro-financial vulnerabilities
Table 2. Possible shocks to the Slovak economy
Figure 7. Financial and housing credit development
Table 3. Housing loans
Longer-term perspectives pose challenges
Figure 8. Foreign trade exposure
Figure 9. Convergence will be hampered by population ageing
Figure 10. The Roma are much younger
Figure 11. The number of emigrants from Slovakia has increased significantly
Preserving healthy public finances
Box 2. A steady implementation of the 2012 pension reform is crucial
Figure 12. Structural reforms and fiscal measures can ensure sustainability
Table 4. Past OECD recommendations on fiscal policy
A more efficient public sector
Figure 13. Efficiency of VAT collection
Table 5. Past OECD recommendations on taxation
Figure 14. Taxes in the Slovak Republic
Figure 15. Composition of general government spending
Figure 16. Public investment spending
Figure 17. Effectiveness of public administration
Table 6. Past OECD recommendations on raising the efficiency of public spending
Figure 18. Perception of the effectiveness of judicial system
Table 7. Past OECD recommendations on improving the judicial system and fighting corruption
Further enhancing the business environment in the non-tradable sectors
Figure 19. The business environment
Table 8. Past OECD recommendations on product market reforms
Improving labour market performance
Figure 20. Mothers with young children tend to withdraw from the labour market
Encouraging women to join the labour market
Figure 21. Mothers with small children face incentives to work
Reducing long-term unemployment
Figure 22. Long-term unemployment is high
Figure 23. Low spending in active labour market policies
Table 9. Past OECD recommendations on the labour market
Enhancing Roma integration
Figure 24. Roma’s employment is low
Promoting a deeper rental housing market to improve workers’ mobility and reduce regional imbalances
Figure 25. Regional economic inequalities
Figure 26. Regional mobility and housing indicators
Table 10. Past OECD recommendations on the housing sector
Enhancing skills to better meet labour market demand and foster inclusive productivity
Figure 27. Adult skills in literacy and problem solving
Figure 28. Teachers are amongst the lowest paid in the OECD
Table 11. Past OECD recommendations on education
Figure 29. Roma student performance is weak
Figure 30. A low proportion of young adults have high-level literacy skills
Figure 31. Slovak researchers produce many publications, but their average quality is poor
Figure 32. Qualification and education mismatches among young tertiary educated graduates are high
Figure 33. Many Slovak students study abroad and only few foreigners study in the Slovak Republic
Improving well-being and sustainable development
A more efficient health-care system would enhance well-being
Figure 34. Health-care spending and outcomes
Figure 35. Health inequalities and perceived mismanagement
Figure 36. Potential efficiency gains in health care
Figure 37. Hospital care
Figure 38. Primary care indicators
Figure 39. Pharmaceutical and other medical goods and service spending
Figure 40. Long-term care
Improving environmental outcomes
Figure 41. Green growth indicators: Slovak Republic
Figure 42. Deaths from ambient air pollution
Table 12. Past OECD recommendations on the environment
Bibliography
Annex.
Progress in structural reform
Thematic chapters
Chapter 1.
Enhancing advanced skills to better meet labour market demand
Better skilled workers will be needed
Figure 1.1. Risk of job loss due to automation
The education system does not presently prepare young people for changes in the labour market
Figure 1.2. Adult skills in literacy and problem solving
This leads to labour shortages and high structural unemployment
Figure 1.3. Companies are increasingly having problems to find skilled and educated workers
Improving skills formation at secondary schools
Figure 1.4. Schools and labour market outcomes are weak
Upgrading the quality of teaching
Figure 1.5. Teachers are amongst the lowest paid in the OECD
Figure 1.6. Higher salaries are important to raise the attractiveness of the teaching profession
Vocational schools should provide a mix of general and practical skills
Figure 1.7. Share of vocational programme enrolment rates in upper secondary education
Box 1.1. VET reform
Figure 1.8. Slovak VET students’ skills are unsatisfactory
Selectivity is harming skills formation
Figure 1.9. Impact of socio-economic status1 on students’ learning outcomes
Figure 1.10. Major risks for socio-economically disadvantaged children becoming low-performing students
Figure 1.11. Roma have poor school attendance resulting in weak skills
Boosting skills in tertiary education
Improving the quality of tertiary education institutions
Figure 1.12. Tertiary education has expanded
Figure 1.13. A low proportion of young adults have high-level literacy skills
Figure 1.14. Slovak researchers produce many publications, but they could be improved in terms of quality
Box 1.2. Tertiary education funding – main features
The tertiary education system should be more linked to the labour market
Figure 1.15. Tertiary education system lacks vocational bachelor programs
Box 1.3. Skills mismatch and worker characteristics
Figure 1.16. Qualification and education mismatches among young tertiary educated graduates are high
Figure 1.17. Mismatched workers suffer wage penalties, despite similar skills to well-matched workers
Figure 1.18. The skills assessment system is underdeveloped
Securing the skills of the workforce over time
Attracting skilled workers, including returning migrants
Figure 1.19. The stock of emigrants has increased significantly
Figure 1.20. The impact of brain drain on the competitiveness1 is substantial
Figure 1.21. Many Slovak students study abroad and only few foreigners study in the Slovak Republic
Figure 1.22. The Blue Card treshold is more restrictive in the Slovak Republic than in other selected OECD countries
Strengthening lifelong learning is necessary to secure the supply of skills over time
Figure 1.23. The relative unemployment rate of individuals with lower secondary versus tertiary education
Figure 1.24. Participation in life-long learning across Europe by educational attainment
Recommendations to enhance advanced skills
Bibliography
Chapter 2.
Improving the efficiency and outcomes of the Slovak health-care system
The health-care system needs to become more effective
Health outcomes are poor, and progress is slow
Figure 2.1. Slovak life expectancy at birth is comparatively low even adjusted for per capita incomes
Figure 2.2. Slovak life expectancy outcomes are relatively poor
Table 2.1. Health outcome performance
Large health inequalities exist between the Roma and non-Roma population
Figure 2.3. Selected health indicators of the Roma and non-Roma population
Figure 2.4. Regional disparities of infant mortality in OECD countries
Figure 2.5. Health inequalities by socioeconomic status
The operation of the health-care system is a source of deep discontent
Figure 2.6. Satisfaction with the healthcare system
Figure 2.7. Household out-of-pocket expenditure on health care
Figure 2.8. Perception of corruption in the public healthcare sector
Figure 2.9. Average waiting days for elective surgery
Health spending has increased sharply since 2000
Figure 2.10. Growth of health-care spending
Figure 2.11. Expenditure on health
There seems to be significant room for improving the efficiency of the health-care system
Figure 2.12. Potential efficiency gains in health care
A more effective health-care system would have economic and fiscal benefits and promote well-being
Table 2.2. Projected increases in public health and long term care spending by main source, 2010-60
Improving the health-care system will require reforms in several areas
Increasing the coherence of the organisation of the system
Box 2.1. The Slovak health-care system
Figure 2.13. Health administrative spending by type of healthcare system
Modernising hospital management and services
Figure 2.14. Hospital care supply
Figure 2.15. Nurses related indicators
Improving the efficiency and quality of primary health care
Figure 2.16. Mortality from selected diseases
Figure 2.17. Primary care indicators
Figure 2.18. Physician density and activity
Figure 2.19. Age structure of physicians
Figure 2.20. Emigration rates of doctors
Pursuing efforts to bring down pharmaceutical expenditure and other ancillary health-care spending
Figure 2.21. Pharmaceutical expenditure
Figure 2.22. Other medical goods and ancillary health services
Developing a long-term care strategy
Figure 2.23. Long-term care
Promoting healthier lifestyles
Figure 2.24. Life style indicators
Figure 2.25. Selected indicators of Roma versus non-Roma living conditions
Recommendations to improve the health-care system
Bibliography
Appendix 1.A1
Health outcome performance

Citation preview

OECD Economic Surveys SLOVAK REPUBLIC JUNE 2017

OECD Economic Surveys: Slovak Republic 2017

This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area.

Please cite this publication as: OECD (2017), OECD Economic Surveys: Slovak Republic 2017, OECD Publishing, Paris. http://dx.doi.org/10.1787/eco_surveys-svk-2017-en

ISBN 978-92-64-27753-3 (print) ISBN 978-92-64-27754-0 (PDF) ISBN 978-92-64-27755-7 (epub)

Series: OECD Economic Surveys ISSN 0376-6438 (print) ISSN 1609-7513 (online)

OECD Economic Surveys: Slovak Republic ISSN 1995-3526 (print) ISSN 1999-0588 (online)

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TABLE OF CONTENTS

Table of contents Basic statistics of Slovak Republic, 2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8 9

Assessment and recommendations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Maintaining solid growth in living standards over the longer term will be challenging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Improving labour market performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Improving well-being and sustainable development . . . . . . . . . . . . . . . . . . . . . . . . .

13 17 34 47

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

56

Annex. Progress in structural reform. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

61

Thematic chapters Chapter 1. Enhancing advanced skills to better meet labour market demand . . . . . . . Better skilled workers will be needed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Improving skills formation at secondary schools . . . . . . . . . . . . . . . . . . . . . . . . . . . . Boosting skills in tertiary education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Securing the skills of the workforce over time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recommendations to enhance advanced skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

67 68 71 79 90 96

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

97

Chapter 2. Improving the efficiency and outcomes of the Slovak health-care system . . . 101 The health-care system needs to become more effective . . . . . . . . . . . . . . . . . . . . . 102 Improving the health-care system will require reforms in several areas. . . . . . . . . 114 Recommendations to improve the health-care system . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Appendix 1.A1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Boxes 1. Slovakia’s high reliance on the automotive industry . . . . . . . . . . . . . . . . . . . . . . 2. 1.1. 1.2. 1.3. 2.1.

19 A steady implementation of the 2012 pension reform is crucial . . . . . . . . . . . . 25 VET reform . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Tertiary education funding – main features. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Skills mismatch and worker characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 The Slovak health-care system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

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Tables 1. Macroeconomic indicators and projections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 2. Possible shocks to the Slovak economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 3. Housing loans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 4. Past OECD recommendations on fiscal policy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 5. Past OECD recommendations on taxation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 6. Past OECD recommendations on raising the efficiency of public spending . . . 31 7. Past OECD recommendations on improving the judicial system and fighting corruption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 8. Past OECD recommendations on product market reforms . . . . . . . . . . . . . . . . . 34 9. Past OECD recommendations on the labour market . . . . . . . . . . . . . . . . . . . . . . 37 10. Past OECD recommendations on the housing sector . . . . . . . . . . . . . . . . . . . . . . 40 11. Past OECD recommendations on education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 12. Past OECD recommendations on the environment . . . . . . . . . . . . . . . . . . . . . . . 56 2.1. Health outcome performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104 2.2. Projected increases in public health and long term care spending by main source, 2010-60 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Figures 1. Slovakia is performing strongly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Poverty and inequality are low but some other well-being dimensions lag behind . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Slovakia’s GDP per capita is catching up, but its population is ageing . . . . . . . 4. The biggest share of Slovakia’s exports is vehicles and most exports go to EU countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. The car industry in the Slovak republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. Evolution of macro-financial vulnerabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. Financial and housing credit development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. Foreign trade exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Convergence will be hampered by population ageing . . . . . . . . . . . . . . . . . . . . . 10. The Roma are much younger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. The number of emigrants from Slovakia has increased significantly . . . . . . . . 12. Structural reforms and fiscal measures can ensure sustainability . . . . . . . . . . 13. Efficiency of VAT collection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14. Taxes in the Slovak Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15. Composition of general government spending . . . . . . . . . . . . . . . . . . . . . . . . . . . 16. Public investment spending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17. Effectiveness of public administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18. Perception of the effectiveness of judicial system . . . . . . . . . . . . . . . . . . . . . . . . 19. The business environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20. Mothers with young children tend to withdraw from the labour market . . . . . 21. Mothers with small children face incentives to work . . . . . . . . . . . . . . . . . . . . . 22. Long-term unemployment is high. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23. Low spending in active labour market policies . . . . . . . . . . . . . . . . . . . . . . . . . . . 24. Roma’s employment is low. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25. Regional economic inequalities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26. Regional mobility and housing indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 1.1. 1.2. 1.3. 1.4. 1.5. 1.6. 1.7. 1.8. 1.9. 1.10. 1.11. 1.12. 1.13. 1.14. 1.15. 1.16. 1.17. 1.18. 1.19. 1.20.

Adult skills in literacy and problem solving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Teachers are amongst the lowest paid in the OECD . . . . . . . . . . . . . . . . . . . . . . . Roma student performance is weak . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A low proportion of young adults have high-level literacy skills . . . . . . . . . . . . Slovak researchers produce many publications, but their average quality is poor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Qualification and education mismatches among young tertiary educated graduates are high . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Many Slovak students study abroad and only few foreigners study in the Slovak Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health-care spending and outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Health inequalities and perceived mismanagement . . . . . . . . . . . . . . . . . . . . . . Potential efficiency gains in health care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hospital care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Primary care indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pharmaceutical and other medical goods and service spending . . . . . . . . . . . . Long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Green growth indicators: Slovak Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Deaths from ambient air pollution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Risk of job loss due to automation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Adult skills in literacy and problem solving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Companies are increasingly having problems to find skilled and educated workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Schools and labour market outcomes are weak . . . . . . . . . . . . . . . . . . . . . . . . . . Teachers are amongst the lowest paid in the OECD . . . . . . . . . . . . . . . . . . . . . . . Higher salaries are important to raise the attractiveness of the teaching profession . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Share of vocational programme enrolment rates in upper secondary education. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Slovak VET students’ skills are unsatisfactory . . . . . . . . . . . . . . . . . . . . . . . . . . . Impact of socio-economic status on students’ learning outcomes . . . . . . . . . . Major risks for socio-economically disadvantaged children becoming low-performing students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Roma have poor school attendance resulting in weak skills. . . . . . . . . . . . . . . . Tertiary education has expanded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A low proportion of young adults have high-level literacy skills . . . . . . . . . . . . Slovak researchers produce many publications, but they could be improved in terms of quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tertiary education system lacks vocational bachelor programs . . . . . . . . . . . . . Qualification and education mismatches among young tertiary educated graduates are high . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mismatched workers suffer wage penalties, despite similar skills to well-matched workers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The skills assessment system is underdeveloped. . . . . . . . . . . . . . . . . . . . . . . . . The stock of emigrants has increased significantly . . . . . . . . . . . . . . . . . . . . . . . The impact of brain drain on the competitiveness is substantial . . . . . . . . . . .

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TABLE OF CONTENTS

1.21. Many Slovak students study abroad and only few foreigners study in the Slovak Republic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.22. The Blue Card treshold is more restrictive in the Slovak Republic than in other selected OECD countries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.23. The relative unemployment rate of individuals with lower secondary versus tertiary education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.24. Participation in life-long learning across Europe by educational attainment . . . 2.1. Slovak life expectancy at birth is comparatively low even adjusted for per capita incomes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.2. Slovak life expectancy outcomes are relatively poor . . . . . . . . . . . . . . . . . . . . . . 2.3. Selected health indicators of the Roma and non-Roma population . . . . . . . . . 2.4. Regional disparities of infant mortality in OECD countries. . . . . . . . . . . . . . . . . 2.5. Health inequalities by socioeconomic status . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.6. Satisfaction with the healthcare system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.7. Household out-of-pocket expenditure on health care . . . . . . . . . . . . . . . . . . . . . 2.8. Perception of corruption in the public healthcare sector. . . . . . . . . . . . . . . . . . . 2.9. Average waiting days for elective surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.10. Growth of health-care spending . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.11. Expenditure on health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.12. Potential efficiency gains in health care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.13. Health administrative spending by type of healthcare system. . . . . . . . . . . . . . 2.14. Hospital care supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.15. Nurses related indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.16. Mortality from selected diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.17. Primary care indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.18. Physician density and activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.19. Age structure of physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.20. Emigration rates of doctors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.21. Pharmaceutical expenditure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.22. Other medical goods and ancillary health services . . . . . . . . . . . . . . . . . . . . . . . 2.23. Long-term care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.24. Life style indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2.25. Selected indicators of Roma versus non-Roma living conditions. . . . . . . . . . . .

6

93 94 95 95 102 103 105 106 106 107 107 108 109 110 111 112 118 120 122 124 125 126 127 127 130 131 133 136 137

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

This Survey is published on the responsibility of the Economic and Development Review Committee of the OECD, which is charged with the examination of the economic situation of member countries. The economic situation and policies of the Slovak republic were reviewed by the Committee on 6 April 2017. The draft report was then revised in the light of the discussions and given final approval as the agreed report of the whole Committee on 23 May 2017. The Secretariat’s draft report was prepared for the Committee by Claude Giorno and Gabriel Machlica under the supervision of Peter Jarrett. The Survey also benefitted from consultancy work by Martin Haluš, Kristína Londáková, Michaela ern nko, Dávid Martinák and Ján Toman. Statistical assistance was provided by Paula Adamczyk, Béatrice Guerard and Eun Jung Kim and editorial assistance by Amelia Godber. The previous Survey of the Slovak Republic was issued in November 2014. Information about the latest as well as previous Surveys and more information about how Surveys are prepared is available at www.oecd.org/eco/surveys.

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BASIC STATISTICS OF SLOVAK REPUBLIC, 2016 (Numbers in parentheses refer to the OECD average)* LAND, PEOPLE AND ELECTORAL CYCLE Population density per km2

Population (million)

5.4

110.7

(37.2)

Under 15 (%)

15.2

(17.9) Life expectancy (years, 2014)

76.9

(80.6)

Over 65 (%)

14.4

(16.6)

Men

73.3

(77.9)

Women

80.5

(83.3)

Foreign-born (%, 2013)

3.3

Latest 5-year average growth (%)

0.1

(0.6) Latest general election

March 2014

ECONOMY Gross domestic product (GDP)

Value added shares (%)

In current prices (billion USD)

89.6

Primary sector

3.8

(2.5)

In current prices (billion EUR)

81.0

Industry including construction

34.8

(26.6)

Services

61.4

(70.7)

Latest 5-year average real growth (%) Per capita (000 USD PPP)

2.5

(1.9)

31.2

(42.1)

GENERAL GOVERNMENT Per cent of GDP Expenditure

41.6

(40.9) Gross financial debt

59.1

(111.8)

Revenue

40.0

(38.9) Net financial debta

35.7

(72.8)

EXTERNAL ACCOUNTS Exchange rate (EUR per USD)

0.904

PPP exchange rate (USA = 1)

0.478

Main exports (% of total merchandise exports)

In per cent of GDP

Machinery and transport equipment

61.0

Manufactured goods

16.4

Exports of goods and services

93.8

(53.9)

Imports of goods and services

90.1

(49.3) Main imports (% of total merchandise imports)

Current account balance

-0.7

Net international investment position (2014)

(0.3)

-62.9

Miscellaneous manufactured articles

9.2

Machinery and transport equipment

48.3

Manufactured goods

15.0

Miscellaneous manufactured articles

12.9

LABOUR MARKET, SKILLS AND INNOVATION Employment rate for 15-64 year-olds (%)

64.9

(67.0) Unemployment rate, Labour Force Survey (age 15 and over) (%)

Men

71.4

(74.7)

Youth (age 15-24, %)

Women

58.3

(59.3)

Long-term unemployed (1 year and over, %, 2015)

70.9

(71.3) Tertiary educational attainment 25-64 year-olds (%, 2015)

Participation rate for 15-64 year-olds (%, 2015) Average hours worked per year (2015)

1 754

(1 766) Gross domestic expenditure on R&D (% of GDP, 2015)

9.7

(6.3)

22.2

(13.0)

7.1

(2.2)

21.1

(35.0)

1.2

(2.4)

(9.3)

ENVIRONMENT Total primary energy supply per capita (toe, 2015) Renewables (%, 2015) Exposure to air pollution (more than 10 µg/m3 of PM2.5, % of population, 2015)

3.0

(4.1) CO2 emissions from fuel combustion per capita (tonnes, 2014)

5.4

8.5

(9.6) Water abstractions per capita (1 000 m3, 2014)

0.1

Municipal waste per capita (tonnes, 2015) 100.0

0.3

(0.5)

(75.2)

SOCIETY Income inequality (Gini coefficient, 2013) Relative poverty rate (%, 2013) Median disposable household income (000 USD PPP, 2013)

0.269

(0.311) Education outcomes (PISA score, 2015)

8.4

(11.1)

Reading

453

(493)

14.2

(22.0)

Mathematics

475

(490)

Science

461

(493)

Public and private spending (% of GDP) Health care (2015)

7.0

(9.0) Share of women in parliament (%)

20.0

(28.7)

Pensions (2013)

7.6

(9.1) Net official development assistance (% of GNI)

0.12

(0.39)

Education (primary, secondary, post sec. non tertiary, 2013)

2.7

(3.7)

Better life index: www.oecdbetterlifeindex.org * Where the OECD aggregate is not provided in the source database, a simple OECD average of latest available data is calculated where data exist for at least 29 member countries. Source: Calculations based on data extracted from the databases of the following organisations: OECD, International Energy Agency, World Bank, International Monetary Fund and Inter-Parliamentary Union.

OECD Economic Surveys: Slovak Republic © OECD 2017

Executive summary

The Slovak economy has been growing strongly Inclusiveness needs to be improved Enhancing public-sector efficiency to raise living standards for all

9

EXECUTIVE SUMMARY

The Slovak economy has been growing strongly The Slovak Republic continues to exhibit robust economic performance. International competitiveness is strong, fiscal and financial policies are prudent, poverty and income inequality are low, and the country’s environmental footprint has improved markedly. Employment is rising, prices have been stable, and the external account is near balance. However, population ageing, which is projected to be one of the sharpest in the OECD, will pose a long-term challenge for fiscal policy and higher living standards.

Growth is strong, but will weaken because of population ageing GDP per capita 6

OECD

Slovak Republic

5 4 3 2

0

2000 2003 2006 2009 2012 2015 2018 2021 2024 2027 2030 2033 2036 2039 2042 2045 2048 2051 2054 2057 2060

1

Source: OECD (2017), OECD Economic Outlook: Statistics and Projections (database). 1 2 http://dx.doi.org/10.1787/888933499885

Inclusiveness needs to be improved Roma employment and health status % 80

Years 80

60

60

40

40

20

20

0

Overall Roma population Employment rate, 2015

Non-Roma

Roma

0

Life expectancy¹, 2013

1. Covers areas with Roma community representing 10 to 25% of the total population. Source: European Union Agency for Fundamental Rights (2016) and B. Gavurová et al. (2014). 1 2 http://dx.doi.org/10.1787/888933499895

The benefits of growth have not been equitably shared. The Roma are not well integrated in society. Their weak integration is reflected in poor health, education and employment outcomes, and poses an ongoing ch a l l e n g e t o t h e i n c l u s ive n e s s o f e c o n o m i c performance. Together with low regional labour mobility, it contributes to large disparities between Bratislava and the eastern part of the country. Another social challenge concerns young mothers: they stay out of the labour force too long because of lack of quality childcare and of insufficient take-up of paternity leave. This has negative effects on gender equity.

Enhancing public-sector efficiency to raise living standards for all Educational outcomes have declined, and the education system does not do a good enough job preparing students Average of mean score in science, reading and mathematics for the labour market. Long-term unemployment is high, despite a strong labour market. At the same time, many 510 OECD Slovak Republic young talented Slovaks are studying and working abroad. 500 For its part productivity is hindered by a poor business 490 environment in the non-tradables sector, especially in professional services and network industries. Important 480 public-sector weaknesses, including low efficiency, 470 widespread corruption and inadequate infrastructure hinder inclusive growth. Population ageing will put 460 2006 2009 2012 2015 increasing pressure on the health-care system, which Source: OECD (2016), PISA 2015 Results (Volume I): Excellence and Equity already suffers from poor efficiency and generates in Education. 1 2 http://dx.doi.org/10.1787/888933499901 mediocre health-care outcomes.

Students’ education outcomes are weak and deteriorating

10

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

EXECUTIVE SUMMARY

MAIN FINDINGS

KEY RECOMMENDATIONS

Fiscal and financial policies and public-sector reforms The economy continues to expand but with growing tensions on capacity and swiftly rising housing loans.

Stand ready to further tighten macro-prudential policy settings if financial-sector risks do not diminish.

The fiscal situation is healthy, as strong growth and efforts to boost tax collection are generating rapid revenue growth. Priority areas for improvement are education and Roma integration. In the medium term population ageing will put pressure on spending.

Pursue budget balance by 2019 as planned.

The existing debt ceiling is not an effective operational fiscal rule and entails the risk of pro-cyclical policy when debt approaches the ceiling.

Supplement the current debt ceilings with a much lower nonbinding debt target, and implement the promised expenditure ceilings.

Despite considerable progress, tax evasion remains substantial.

Merge the tax/customs and social security agencies to raise revenues.

Increase public-spending efficiency by expanding and deepening spending reviews (“Value for Money” initiatives) to allow higher spending in priority areas such as education and Roma integration.

Link the IT systems of the tax administration and banks. The tax mix imposes too high a tax burden on low-skilled workers.

Further shift the tax burden from labour to less distortive bases such as real estate, alcohol and environmental externalities such as air pollution.

Air quality suffers from heavy use of brown coal in power generation.

Remove support for brown coal mining in electricity generation.

Corruption is still perceived to be a problem.

Proceed with the OECD audit and integrity assessment of anti-corruption laws. Ensure proper implementation of all recommendations. Fostering inclusiveness and well-being

The weak integration of Roma is a serious inclusiveness challenge.

Raise pre-school attendance of the poor with conditional cash transfers. Promote Roma access to health care by increasing support for trained Roma mediator programmes. Develop statistics to monitor the effectiveness of support to the Roma.

Weak geographic labour mobility contributes to regional disparities and reflects in part an underdeveloped rental market.

Phase out financial incentives for homeownership.

Amenable mortality is high, reflecting poor primary health care and a lack of general practitioners (GPs).

Further increase medical school places for GPs, and expand their prescription-writing authority.

Develop long-term rental contracts better protecting landlords’ rights, while ensuring stability and predictability for tenants.

Expand fee-for-service payments for GPs primary care procedures. Hospital-care financing is deficient, and management is poor. There are too many acute-care beds.

Phase in the diagnosis-related-group-based hospital financing system. Further centralise hospital procurement, professionalise their management and decouple salaries from national average wage. Further cut the number of acute-care beds.

The supply of long-term care for dependent people is underdeveloped and fragmented.

Create regional one-stop shops with well-trained personnel to coordinate and simplify access to long-term care services.

Boosting skills, employment and productivity Educational outcomes are below the OECD average and declining, in part due to poorly motivated and trained teachers.

Further increase teachers’ salaries, particularly for starting teachers, conditional on improved teaching quality through high-quality professional development and increased focus on disadvantaged pupils.

There is substantial scope to raise the quality of university research. Tertiary education does not properly prepare students for the labour market.

Increase the transparency and independence of the tertiary qualityassurance framework to international standards. Boost the funding of internationally recognised research. Introduce a graduate tracking system to improve the responsiveness of tertiary education to labour market needs.

Skilled workers are in short supply. Emigration and young mothers’ work disincentives are reducing employment and harming inclusive growth.

Simplify work visa and residence procedures for skilled workers. Expedite the expansion of high-quality early childcare. Make some of the currently long parental leave available only to fathers.

Productivity in non-tradable sectors is hindered by barriers to entrepreneurship.

Lower licencing restrictions for legal services, architects and engineers. Further reduce public-sector involvement in network industries.

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

11

OECD Economic Surveys: Slovak Republic © OECD 2017

Assessment and recommendations

Maintaining solid growth in living standards over the longer term will be challenging Improving labour market performance Improving well-being and sustainable development

13

ASSESSMENT AND RECOMMENDATIONS

S

lovakia’s economy continues to perform extremely well both in terms of macroeconomic outcomes and public finances (Figure 1). GDP growth exceeded 3½ per cent on average in 2015 and 2016 and is projected to stay strong in the next two years. Prices have been stable, the unemployment rate has fallen below 10% – its lowest level in seven years – and the current account is near balance. The fiscal situation is solid, with a deficit of well below 2% of GDP in 2016 and a public debt around 52% of GDP, far below the OECD average. International competitiveness, fiscal and financial stability and ample foreign direct investment (FDI) are all contributing to a sustained rise in living standards.

Figure 1. Slovakia is performing strongly A. Real GDP Index 2001 = 100

B. Gross public debt % of GDP 140

180

SVK

CZE

170

HUN

POL

160

OECD

Slovak Republic, Maastricht definition

120

OECD 100

150 80

140

60

130 120

40

110 20

100 90

2001

2003

2005

2007

2009

2011

2013

2015

0

2001

2003

2005

2007

2009

2011

2013

2015

Source: OECD (2017), OECD Economic Outlook: Statistics and Projections (database). 1 2 http://dx.doi.org/10.1787/888933499912

Slovaks also do as well as or better than the OECD average on a number of dimensions of well-being, though average incomes still lag behind (Figure 2). To some extent, high well-being reflects the fairly low poverty rate (with only 8% of the population living in households with less than 50% of the median disposable income, which measures the relative poverty, and only 2% living with less than the income threshold measuring the absolute terms) and relatively even income distribution (the ratio of the average income of the 10% richest households to average income of the 10% poorest households is low by international comparisons). Work-life balance and social connections indicators are also good. However, as in many countries, per capita growth has fallen since 2008-09, and the catch-up process has slowed (Figure 3, Panel A). Moreover, population ageing, projected to be one of the steepest in the OECD on the basis of the expected change in old-age dependency ratio (Panel B), will pose policy and social challenges in the decades ahead. They will be compounded by the persistent emigration of young and educated people, as

14

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

ASSESSMENT AND RECOMMENDATIONS

Figure 2. Poverty and inequality are low but some other well-being dimensions lag behind A. Well-being¹ SVK Income and wealth 0.8

Subjective well-being

OECD Jobs and earnings

0.6

Personal security

0.4

Housing

0.0

20 16 12

0.2

Environment al quality

%

B. Poverty rate relative to threshold of 50% of median disposable income 2013 or nearest year

8

Work and life balance

4

Civic engagement and governance

ISR

TUR

CHL

ESP

ESP

EST

PRT

GRC

GRC

OECD²

POL

HUN

SVN

AUT

SVK

0

Education and skills

CZE

Social connections

FIN

Health status

C. Income inequality S90/S10 income share ratio3, 2013

% 24 20 16 12 8

CHL

USA

ISR

ITA

EST

LVA

PRT

GBR

LTU

CAN

KOR

OECD

IRL

POL

FRA

CHE

AUT

DEU

NLD

SVK

LUX

SWE

NOR

BEL

CZE

SVN

FIN

ISL

0

DNK

4

1. Each well-being dimension is measured by one to four indicators from the OECD Better Life Index database. Normalised indicators are averaged with equal weights. Indicators are normalised based on 38 countries except for health performance status (35 member countries). Normalised indicators range between 1 (best) and 0 according to the following formula: (indicator value – minimum value)/ (maximum value – minimum value). 2. Unweighted average. 3. S90/S10 income share ratio is the ratio of the average disposable income of the top 10% richest households to the average income of the 10% poorest households. Source: OECD (2016), “Income distribution and Poverty” and “Better Life Index 2016”, OECD Social and Welfare Statistics (database). 1 2 http://dx.doi.org/10.1787/888933499925

well as the weak integration of Roma. Other challenges are the work disincentives faced by women and high long-term unemployment, including for youth. Widely different labour market outcomes between Bratislava and the eastern part of the country also contribute to large regional per capita GDP gaps and a dual functioning of the economy, as discussed in the previous Survey (OECD, 2014a). To a large extent, these problems reflect the persistence of substantial public-sector deficiencies. These include generally low efficiency, high levels of perceived corruption and inadequate infrastructure. The education system faces difficulties in developing individuals’ human capital and enabling them to realise their potential to adapt to the needs of the labour market and future technological changes. Structural weaknesses also

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

15

ASSESSMENT AND RECOMMENDATIONS

Figure 3. Slovakia’s GDP per capita is catching up, but its population is ageing A. Gaps in GDP per capita Gap to the OECD average¹

B. Change in old-age dependency ratio² 2015-60

%

% 45

-10

40 -20

35 30

-30

25 20

-40

15 10

-50

POL

SVK

PRT

CZE

SVN

HUN

ESP

AUT

DEU

EU28

FIN

DNK

BEL

0

FRA

2015

2013

2011

2009

2007

2005

2003

2001

1999

1997

1995

-60

1993

5

1. Percentage gap of per capita GDP expressed in constant 2010 PPPs. 2. Elderly persons (65 and over) as a share of the working-age population (15-64). 3. Unweighted average. Source: OECD (2016), Eurostat (2017). 1 2 http://dx.doi.org/10.1787/888933499935

affect the health-care system where, despite strong increases in spending, health outcomes of the population have remained relatively weak, undermining productivity and well-being (Figure 2, Panel A). Moreover, there has been no progress in improving housing adequacy, as proxied by the number of rooms per person, and one in ten Slovaks report low life satisfaction. The authorities have continued their reform process over the last few years to address these issues. Some improvement has been achieved in the domain of public sector efficiency, thanks in particular to significantly better tax collection. Steps have been taken to enhance public procurement procedures in hospitals. Reforms have also started in the area of vocational education and training to develop a dual system relying on work-based learning. However, the pace of structural reforms in 2015-16 seems to have slowed compared with 2013-14 (OECD, 2017a), no doubt in part because of the electoral timetable. Against this background, the main messages of this Survey are: Growth is strong as the country has remained attractive for FDIs thanks to appropriate macroeconomic policies. This situation offers an opportunity to address remaining weaknesses and thereby set the stage for making growth more inclusive and further increasing the living standards of all Slovaks. Making growth more inclusive for the Roma, women and the chronically unemployed will require reforms in education, health-care and the labour market, along with better infrastructure. Improving the integration of disadvantaged groups, especially Roma, into society is crucial. The government appropriately intends to reach a balanced budget or better by 2019 to maintain the soundness of the public finances. Thus, the budgetary resources needed to pursue further inclusiveness-friendly reforms will have to be found from enhanced tax collection, the wide scope for efficiency gains and reprioritisation in public spending.

16

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

ASSESSMENT AND RECOMMENDATIONS

Maintaining solid growth in living standards over the longer term will be challenging The Slovak economy continues to expand in the short term Robust growth continued in 2016 on the back of household consumption, underpinned by a stronger labour market and rising confidence. Improved household finances and low mortgage rates have led to a house-price pick-up of almost 10% since 2014. Investment activity has temporarily declined, as the boost from exceptional 2015 EU structural funds absorption faded at the start of the new financing period. However, business investment has remained strong, supported by low interest rates and major capital projects in the automotive sector. Integration in global value chains, especially in the form of vehicle assembly investments, coupled with a jump in tourism, has helped Slovakia to increase its export market shares. Consumer price inflation remains low albeit increasing as elsewhere. Growth is projected at between 3½ and 4% in 2017 and 2018 (Table 1). The continued expansion of the automotive sector should further boost investment and exports. Car exports were 27% of Slovak exports in 2015 (Figure 4, Panel A), and production will reach 1.4 million units by 2018 (Box 1), most of which go to EU countries (Panel B), though their ultimate destination is unclear. As a consequence, the current account balance should soon turn positive.

Figure 4. The biggest share of Slovakia’s exports is vehicles and most exports go to EU countries B. Export structure by destinations

A. Export structure by commodities

DEU Vehicles

Other

Other

CZE ESP ITA Electric equipment

Iron and steel Machinery and equipment

PLN

HUN AUT

GBR

FRA

Source: Statistical Office of the Slovak Republic (2016), “Yearbook Development of Foreign Trade in the Slovak Republic 2011-15”, December. 1 2 http://dx.doi.org/10.1787/888933499941

The labour market should benefit from a stronger economy. Employment and hours worked are the highest since independence and will continue to increase, entailing a drop in the unemployment rate to around 7½ per cent by end-2018. However, employers are voicing concern about workforce quality. Shortages affect over half of all manufacturers and are particularly acute in the automotive sector. In 2016 more than 80% of the sector’s suppliers signalled that labour availability and quality were major problems. The demand for qualified IT workers is estimated to be four times the supply, and, according to ICT

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

17

ASSESSMENT AND RECOMMENDATIONS

Table 1. Macroeconomic indicators and projections Annual percentage change, volume (2010 prices) 2013 Current prices (EUR billion)

2014

2015

2016

2017

2018

74.2 41.8 13.7 15.4 2.0 70.8 0.2 71.0 69.6 66.4 3.1

2.6 1.4 5.3 1.2 -1.7 2.1 1.1 3.1 3.7 4.4 -0.5

3.8 2.2 5.4 16.9 -11.6 6.0 -1.1 4.7 7.0 8.1 -0.7

3.3 2.9 1.6 -9.3 2.9 -0.3 1.2 1.0 4.8 2.9 1.8

3.3 3.1 0.9 1.2 4.1 2.2 0.0 2.3 6.6 6.6 0.2

4.1 3.2 1.9 7.0 3.4 3.7 0.0 3.6 7.0 6.7 0.6

.. .. .. .. .. ..

2.5 -2.8 1.5 13.2 -0.1 0.5 1.5 1.5 1.4 1.1 -2.7 -2.6 53.6 35.5 0.2 2.1

2.9 -1.9 2.6 11.5 -0.3 0.5 2.6 1.8 3.1 0.2 -2.7 -2.5 52.5 35.3 0.0 0.9

2.8 -1.5 2.8 9.6 -0.5 0.9 2.5 1.3 3.2 -0.7 -1.7 -1.6 51.9 35.7 -0.3 0.5

2.8 -1.1 1.6 8.5 1.6 1.5 4.2 2.4 3.2 -0.2 -1.2 -1.1 51.7 35.5 -0.3 1.0

3.0 0.0 1.4 7.6 2.0 2.0 5.2 2.2 3.2 0.7 -0.6 -0.6 50.2 34.0 -0.3 1.3

GDP Private consumption Government consumption Gross fixed capital formation Housing Final domestic demand Stockbuilding1 Total domestic demand Exports of goods and services Imports of goods and services Net exports1 Other indicators (growth rates, unless specified) Potential GDP Output gap2 Employment Unemployment rate3 Harmonised index of consumer prices Core HICP Wage rate Unit labour costs Household saving ratio, net4 Current account balance5 General government financial balance5 Underlying government financial balance2 Government gross debt (Maastricht)5 Government net debt5 Three-month money market rate, average Ten-year government bond yield, average

.. .. .. .. 40.6 24.2 .. ..

1. Contribution to changes in real GDP. 2. As a percentage of potential GDP. 3. As a percentage of the labour force. 4. As a percentage of household disposable income. 5. As a percentage of GDP. Source: OECD Economic Outlook 100 Database.

employers, 10 000 more specialists (equivalent to 14% of employment of the sector) are needed; that number is expected to double in five years (ITAS, 2016). Wage increases are projected to accelerate to 5% in 2018, reflecting labour shortages and productivity growth. Higher real wages are expected to sustain robust consumption and push up inflation to around 2%, close to the ECB target for the euro area. Macro-financial vulnerabilities have decreased considerably since the financial crisis in almost all dimensions (Figure 6). The authorities consider that the financial situation is sound, as the banks are profitable (although less so than in 2015, as in other euro area countries, because of the contraction of the net interest margin) and have ample liquidity (NBS, 2016a; IMF, 2016a). Their capitalisation is also healthy, non-performing loans are low, and liabilities denominated in foreign currencies are low, though increasing somewhat. The Slovak external position has improved, thanks to better international price and cost competitiveness, leading to a somewhat stronger net international investment position. There are both upside and downside risks to the outlook. Exports will depend in large part on the recovery in Europe, which has recently been looking more promising but could

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ASSESSMENT AND RECOMMENDATIONS

Box 1. Slovakia’s high reliance on the automotive industry The robust economic growth in recent years has been underpinned by the automotive sector. The number of cars produced in Slovakia has increased more than five times over the last decade and reached 1 million vehicles produced per year (Figure 5, Panel A), making Slovakia the largest per capita producer of cars in the world. The sector represents around 40% of the industrial output and one third of exports, with export mostly directed to EU countries, but also China, the United States and Russia (Panel B). Due to the high import intensity, the car industry only accounts for 4% of total value added in the country.

Figure 5. The car industry in the Slovak republic A. Number of produced cars in Slovakia in thousands 1200

%

B. Slovakia's car export by country of destination, 2010-2014

16 14

1000

12 800

10

600

8 6

400

4 200 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

0

2 0

DEU FRA CHN GBR USA

ITA

RUS ESP NLD BEL

Source: ZAP, Kendera, T. (2016), “Na ktorých zahrani ných trhoch sa najviac presadzujú automobily zo Slovenska?”, National Bank of Slovakia, Bratislava. 1 2 http://dx.doi.org/10.1787/888933499954

The automotive sector will continue to drive export and production growth in the coming years. The planned opening of a fourth large car plant by Jaguar Land Rover in 2018 should increase annual car production by 130 000 units, create 7 500 additional jobs within the automotive sector and boost GDP by 1½ per cent over the 2017-20 period (NBS, 2016). The production is located in the western part of the country, where unemployment is below 5% and car manufacturers are already facing a shortage of skilled workers. Upward pressures on wages in the sector are thus likely to intensify in the coming years.

suffer from a disorderly Brexit. However, a slowdown in China would pose risks to the world economy, and thus Slovakia. Rising tensions on capacity, if they persist, could lead to some overheating and a deterioration in international competitiveness. Spreading labour shortages and inadequate labour skills could hinder productivity gains, slowing growth. A close monitoring of wages and labour cost developments is thus desirable, even if there is room to bring more people into the labour force and to further lower unemployment. The economy may also confront several other shocks, including a rise in trade protectionism, whose effects are difficult to factor into the projections (Table 2). The car sector is especially vulnerable to such risks; this would have important external trade effects, given its large export share. Strong growth and very low interest rates have also led to rapid bank lending increases, particularly for housing, at annual rates close to 10% since mid-2016 (Figure 7, Panel A). Since the crisis household indebtedness has risen more sharply than elsewhere, although

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ASSESSMENT AND RECOMMENDATIONS

Figure 6. Evolution of macro-financial vulnerabilities Deviations of indicators from their real time long-term averages (0), with the highest deviations representing the greatest potential vulnerability (+1), and the lowest deviations representing the smallest potential vulnerability (-1)

Q3 2016 (or latest data available)¹

A. Aggregate indicators

B. Individual indicators Capacity utilisation Leverage ratio 1.0 Hours worked

Growth sustainability 1.0

0.5

External bank debt

0.5 Financial stability²

Long-term average

2007²

0.0

Price stability

- 0.5

Productivity gap

0.0

Non-performing loans²

Growth duration

- 0.5 Banks' size

- 1.0

Consumer prices

- 1.0

Corp. net saving¹ Net saving¹

External position

Cost competitiveness

Housh. net saving¹

Price competitiveness

Gov. net saving¹

CA balance NIIP

Note: Each aggregate macro-financial vulnerability indicator is calculated by aggregating (simple average) normalised individual indicators. Growth sustainability includes: capacity utilisation of the manufacturing sector, total hours worked as a proportion of the working-age population (hours worked), difference between GDP growth and productivity growth (productivity gap), and an indicator combining the length and strength of expansion from the previous trough (growth duration). Price stability includes headline and core inflation (consumer prices), and it is calculated by the following formula: absolute value of (core inflation minus inflation target) + (headline inflation minus core inflation). External position includes: the average of unit labour cost based real effective exchange rate (REER), and consumer price based REER (cost competitiveness), relative prices of exported goods and services (price competitiveness), current account (CA) balance as a percentage of GDP and net international investment position (NIIP) as a percentage of GDP. Net saving includes: government, household and corporate net saving, all expressed as a percentage of GDP. Financial stability includes: banks’ size as a percentage of GDP, the share of nonperforming loans in all receivables from loans, external bank debt as percentage of total banks’ liabilities, and capital and reserves as a proportion of total liabilities (leverage ratio). 1. Data on net saving and its components in 2015. 2. Data on non-performing loans in 2010. Source: OECD calculations based on OECD (2017), OECD Economic Outlook: Statistics and Projections (database), OECD (2017), Main Economic Indicators (database), OECD (2017), OECD National Accounts Statistics (database), National Bank of Slovakia, Thomson Reuters Datastream. 1 2 http://dx.doi.org/10.1787/888933499965

Table 2. Possible shocks to the Slovak economy Shock

Possible impact

Reduction in the free movement of goods and labour due to a rise in protectionism.

This would undermine Slovak exports, as the economy is strongly anchored in global value chains.

Increase in geopolitical tensions in and around Europe.

This would hurt confidence and activity in Europe, which would undermine growth.

A hard landing of emerging economies, particularly in China.

Such a shock would affect Slovakia, largely through its strong linkages with the German economy.

its level remains relatively low (Panel B). This has led to a marked increase in banks’ exposure to the housing sector: their share of residential real estate loans in total loans is higher than in most other OECD countries (Table 3). To reduce the risks of a housing bubble and strengthen financial stability, the National Bank of Slovakia has correctly taken proactive measures, making several macro-prudential changes in 2014, which have since been progressively tightened. Since the beginning of 2017 banks have had to limit the share of their new housing loans with a loan-to-value (LTV) ratio exceeding 90% to less than 10%. As from August 2017 they will also have to hold an additional 0.5% countercyclical capital

20

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Figure 7. Financial and housing credit development A. Annual growth of lending to the private sector

30 Slovakia

C. Nominal and real house prices Index 2005 = 100 190

Nominal house prices

170

Real house prices

140 128

PRT

ESP

FIN

GRC

AUT

ISR

EST

SVK

POL

2017M1

2016M1

2015M1

2014M1

0

2013M1

0

2012M1

20 2011M1

6 2010M1

40

2009M1

12

2008M1

60

2007M1

18

CZE

80

SVN

Households¹

24

B. Households' gross debt 2015 or nearest year

% of GDP 100

HUN

%

D. Affordability House price to income ratio, Index 2005 = 100 Slovak Republic OECD

150

104

110

92

90

80

2005Q1 2005Q4 2006Q3 2007Q2 2008Q1 2008Q4 2009Q3 2010Q2 2011Q1 2011Q4 2012Q3 2013Q2 2014Q1 2014Q4 2015Q3 2016Q2

130

2005Q1 2005Q4 2006Q3 2007Q2 2008Q1 2008Q4 2009Q3 2010Q2 2011Q1 2011Q4 2012Q3 2013Q2 2014Q1 2014Q4 2015Q3 2016Q2

116

1. Contribution of households to annual growth for Slovak Republic. Source: OECD (2017), OECD Economic Outlook: Statistics and Projections (database); OECD Analytical House Price Database; and ECB (2017), MFIs Balance Sheets Database. 1 2 http://dx.doi.org/10.1787/888933499974

requirement. These measures may not lower loan growth in the short term. Slovak banks can meet the new capital requirements (NBS, 2016b), and the loan-to-value restrictions are not particularly tight (IMF, 2016a). The authorities must thus stand ready to tighten these macro-prudential measures if risks to the financial system do not diminish and, for instance, further lower LTV ratio limit and/or impose higher credit risk weights on the riskier subcomponents of real estate loans. These credit risk weights, which are currently standardised at 35% for all housing credits, could for instance be increased for mortgage loans with LTV ratios over 80%, in line with the latest Basel proposal (IMF, 2017).

Longer-term perspectives pose challenges Large FDI inflows have helped integrate Slovakia into global value chains and boosted exports and productivity (OECD, 2013a). However, the strong shift to export-oriented production and the high share of jobs linked to trade (Figure 8) have exposed it to the world trade slowdown and the decline of the pace of globalisation since 2008 (Haugh et al., 2016). For Slovakia, this applies especially to the prospects for the automotive sector. In addition, the longer term technological changes may limit future demand for automobiles, if selfdriving cars become a real option. The Slovak Republic has one of the fastest ageing populations in the OECD, as the fertility rate is low, and life expectancy is set to rise substantially with incomes. The Slovak population, which is currently one of the youngest in the EU with a low old-aged dependency

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ASSESSMENT AND RECOMMENDATIONS

Table 3. Housing loans Share in % of total loans 20081

2016 Q3 or most recent available data2

Change

Australia

57.7

63.3

5.6

Austria

11.0

20.2

9.2

Belgium

18.5

14.6

-3.9

Denmark

30.8

36.0

5.2

Canada

32.3

36.0

3.7

Finland

28.8

28.8

0.0

Germany

15.7

18.6

2.8

Greece

20.7

27.6

6.9

Israel

23.5

35.2

11.6

Italy

15.0

19.1

4.1

Netherlands

24.4

23.3

-1.1

Norway

41.4

43.6

2.3

Poland

26.4

31.8

5.4

Portugal

31.9

38.2

6.3

Slovakia

20.6

44.4

23.8

Spain

27.2

30.2

3.0

Sweden

32.3

37.1

4.8

United Kingdom

11.7

20.0

8.3

United States

38.0

31.1

-6.9

1. 2009 for the United States. 2. Q2 2016 for Italy, the United Kingdom, Finland, Greece and Q1 2016 for Norway. Source: IMF Soundness Indicators.

Figure 8. Foreign trade exposure A. Foreign trade openness Average of imports and exports of goods and services

% of GDP 100 Small OECD countries¹

B. Share of domestic employment used in production for foreign final demand 2011

% 50

Hungary, Poland and Czech Republic¹

HUN

0

EST

2014-15

SVK

2007-08

CZE

1995-96

SVN

0

AUT

10

POL

20

PRT

20

FIN

40

ISR

30

CHL

60

ESP

40

Slovak Republic

GRC

80

1. Unweighted average. Source: OECD (2016), OECD Economic Outlook: Statistics and Projections (database); and OECD/WTO (2016), Statistics on Trade in Value Added (Tiva) database – October 2015. 1 2 http://dx.doi.org/10.1787/888933499985

ratio, is projected to become the 8th oldest by 2060. As a consequence, the share of workingage in total population could shrink from 71% today to 55% in 2060, and employment could decrease by a fifth (Figure 9, Panel A) (EC, 2015a).The rate of catch-up of per capita income with the average OECD countries might slow and even reverse in the long term (Panel C).

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Figure 9. Convergence will be hampered by population ageing B. Convergence in productivity level Gap in GDP per worker to the OECD average

A. Potential employment Thousands 2600

10

2400

0

2200

-10

2000

-20

2056

2051

2046

2041

2036

2031

2026

2021

2016

2011

2006

2001

-50

2056

2051

2046

-40

2041

2036

2031

2026

2021

2016

2011

2006

2001

1996

1600 1400

-30

Scenario without Roma integration and no immigration² Reference scenario¹

1996

1800

C. Convergence in GDP per capita Gap to the OECD average 0

0 -10

-10

-20

-20

-30

-30

-40 -50

-50 2060

2058

2056

2054

2052

2050

2048

2046

2044

2042

2040

2038

2036

2034

2032

2030

2028

2026

2024

2022

2020

2018

2016

2014

2012

2010

2008

2006

2004

2002

2000

1998

Reference scenario¹ 1996

-60

-40

Scenario without Roma integration and no immigration²

-60

1. Reference scenario is affected by aging in line with OECD Economic Outlook 100 and European Commission (2015), The 2015 Ageing Report. It includes immigration and assumes Roma’s integration to the labour market in line with non-Roma population. 2. Scenario without Roma integration and no net immigration assumes the current labour market outcomes for the Roma and an increase in their share of the population based on Sprocha (2014). Source: OECD (2017), OECD Economic Outlook No. 100; European Commission (2015), The 2015 Ageing Report: Economic and budgetary projections for the 28 EU Member States (2013-2060); Sprocha, B. (2014), Reprodukcia rómskeho obyvatel’stva na Slovensku a prognóza jeho popula ného vývoja, INFOSTAT – Výskumné demografické centrum; and OECD calculations. 1 2 http://dx.doi.org/10.1787/888933499993

In spite of strong economic growth, social inclusion is weak, particularly for Roma, who are very poorly integrated into the labour market and have long suffered from many disadvantages. Their share in the total population is expected to rise from 8% today to 14-15% by 2060, as they are much younger (Figure 10; Sprocha, 2014). Another challenge relates to emigration. In the last 15 years a net 300 000 Slovaks (or 6% of the population) emigrated, and almost a tenth of Slovak citizens now live abroad (Figure 11). Since 2010, on average almost 0.3% of the population has left the country every year, though in 2016 the number of returning migrants slightly exceeded that of emigrants (Haluš et al., 2017). Emigrants are mostly young and well-educated. One third are between 18 and 26, and those with a tertiary degree are most likely to leave (Haluš et al., 2017). The emigration improves the well-being of the emigrants, but it also contributes to shortages of qualified workers in Slovakia. At the same time, Slovakia has one of the least favourable regimes within the European Union in providing foreign workers access to its labour market, though new legislation effective from May 2017 will result in some easing of the

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ASSESSMENT AND RECOMMENDATIONS

Figure 10. The Roma are much younger A. Roma population by age 2015

B. Non-Roma population by age 2015

Women

Men

101

101

91

91

81

81

71

71

61

61

51

51

41

41

31

31

21

21

11

11

1 -2.5 2.5

-1.5 1.5

0.5-0.5

0.5

1.5

2.5

1 -2.5 2.5

1.5 -1.5

0.5 -0.5

0.5

1.5

2.5

Source: Sprocha, B. (2014), Reprodukcia rómskeho obyvatel’stva na Slovensku a prognóza jeho popula ného vývoja, INFOSTAT – Výskumné demografické centrum. 1 2 http://dx.doi.org/10.1787/888933499995

Figure 11. The number of emigrants from Slovakia has increased significantly Stock of emigrants1

% of resident population 20

% of resident population 20 2013 (or latest year)

Around 2000 16

12

12

8

8

4

4

0

0

USA JPN ESP CHL AUS FRA SWE BEL ISR NOR KOR TUR CAN ITA DEU CZE DNK SVN AUT NLD FIN OECD² HUN CHE GBR GRC EU² EST BGR POL ISL PRT LVA LUX SVK MEX HRV LTU IRL ROU NZL

16

1. Emigration stocks are computed with reference to a sample of 34 OECD countries of destination for which immigrant data by country of birth (stocks) are available. 2. Unweighted average. Source: OECD (2016), OECD International Migration Statistics (database); and OECD Economic Outlook: Statistics and Projections (database). 1 2 http://dx.doi.org/10.1787/888933500014

rules for foreign workers (see Chapter 1). Overall, if both the risks of emigration and nonintegration of Roma were to materialise, the level of per capita GDP would be lowered by 6 percentage points in 2060 relative to the reference scenario, which assumes some increase in immigration and some progress of Roma’s integration.

Preserving healthy public finances The Slovak budgetary framework has been strengthened considerably. An independent fiscal council was established, and transparent debt rules were defined in the constitution

24

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ASSESSMENT AND RECOMMENDATIONS

in 2011. However, this framework is incomplete, as the envisaged binding multi-annual expenditure ceilings, which are also a constitutional provision (Slovak Republic, 2011), have not yet been implemented. According to the Fiscal Responsibility Act, public debt must remain below 60% of GDP, and this legal ceiling will decline annually by one percentage point as from 2018 until it reaches 50% by 2027. As public debt is now over 50% of GDP this ceiling would already be potentially binding if, for example, growth were to slow sharply. This possibility calls for creating more room under the ceiling. In 2009 the government launched a consolidation plan, which reduced the Maastricht measure of the deficit from almost 8% of GDP to 2.7% of GDP in 2013. This allowed Slovakia to exit the European Union’s Excessive Deficit Procedure in 2014 and increased international financial markets’ confidence (OECD, 2014a). In 2016 the deficit fell by a further 1% of GDP to 1.7% of GDP, better than the 1.9% budgetary target. Moreover, the government plan, which is in line with the European Union’s Medium-Term Objective, aims to reach a balanced budget by 2019 in order to further decrease the public debt and deal with the longer-term challenge of population ageing. As illustrated by the baseline scenario in Figure 12, this plan will indeed lower the debt level well below the constitutional ceiling, even if the debt will pick up somewhat again after 2050, because of the fiscal impact of population ageing (Box 2).

Box 2. A steady implementation of the 2012 pension reform is crucial As mentioned above, population ageing in Slovakia will be one of steepest in the OECD, which will expose the public finances to strong pressures in the next few decades. To face this fiscal challenge, a general pension reform was adopted in 2012-13. This broad reform, which streamlined the pension system including special regimes for armed forces and police, is expected to reduce public spending by 3% of GDP by 2060 if it is steadily and fully implemented (OECD, 2014a), in contrast to what happened in 2017 when a more generous increase was accorded. Yet, even if the reform is implemented as originally envisaged, longterm ageing costs are expected to rise by about 3.0% of GDP from 2020 to 2060 (Fiscal Council, 2017). Although this fiscal cost is expected to be felt only after 2050, it will be higher than in most other EU countries, where the budgetary impact of ageing will reach 1.6% of GDP on average (EC, 2015a). Moreover, with replacement rates not particularly high in Slovakia, pensions indexed only on consumer prices as from 2018, and the statutory pensionable age being raised in line with life expectancy from 2017 onwards, other changes in the pension system do not provide much potential room to painlessly ease the pressure from population ageing.

Ensuring a proper implementation of the current fiscal consolidation plan until 2019 is needed as it provides the authorities with more fiscal room for manoeuvre to reduce the risk of being forced to take pro-cyclical measures in case of any unexpected large negative shocks (Figure 12, “Baseline scenario”). Although, as discussed below, there is much need for further promoting inclusiveness-friendly measures in priority spending areas of education and Roma integration, until 2019 these measures should be financed through efficiency gains from both expenditure and revenue sides. There is indeed a considerable scope for improvement in this domain (see below). In the longer term, as the debt will be lower, fiscal room will be larger to finance new structural reforms and additional initiatives in priority spending areas, especially as these measures, if well-designed, have the potential to strengthen growth, make it more inclusive, and further enhance public sector efficiency.

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ASSESSMENT AND RECOMMENDATIONS

Figure 12. Structural reforms and fiscal measures can ensure sustainability General government debt, Maastricht definition

% of GDP

% of GDP 120

120 Baseline¹ Increasing expenditures with long-term gains from structural reforms Debt rule² Increasing expenditures

100

100

2060

2058

2056

2054

2052

2050

2048

2046

2044

2042

2040

2038

2036

2034

2032

2030

2028

2026

2024

2022

2020

2018

0

2016

0

2014

20

2012

20

2010

40

2008

40

2006

60

2004

60

2002

80

2000

80

1. The baseline consists of the projections for the OECD Economic Outlook 100 until 2018. From there on real growth is based on the European Commission ageing report and will grow by 1.7%. The baseline scenario assumes the fiscal balance will reach a surplus of 0.16% of GDP by 2019 with its further development influenced only by the revenues and expenditures sensitive to population ageing based on EC ageing report. The “relaxing the consolidation” assumes government balance will reach deficit of 0.3% of GDP by 2019, thus lower by 0.5% of GDP compare to government plan. The “without consolidation” scenario assumes the current primary deficit at the level of 2015 at 1.2% of GDP with its further development influenced only by the revenues and expenditures sensitive to population ageing based on EC ageing report. 2. Constitutional debt thresholds: 60% of GDP – Vote of confidence procedure against the government. Between 2018 and 2028, the thresholds are to be gradually lowered by 10 percentage points. Source: Calculation based on OECD (2016), OECD Economic Outlook: Statistics and Projections (database); and European Commission (2015), The 2015 Ageing Report: Economic and budgetary projections for the 28 EU Member States (2013-2060). 1 2 http://dx.doi.org/10.1787/888933500033

Although, these latter positive economic effects are difficult to quantify precisely, they are likely to help reduce the fiscal pressure stemming from population ageing (Figure 12, “Increasing expenditures with long-term gains from structural reforms”). Nevertheless, it would be prudent for the authorities to maintain an adequate fiscal buffer. To this end, they should consider improvements to the fiscal framework to prevent the debt from returning to levels close to the constitutional ceiling, in case, for instance, of inefficient spending (Figure 12, “Higher expenditures”). In this regard, a useful reform would be to supplement the debt ceiling with a debt target that is well below the ceiling. This debt target would provide an anchoring guide for fiscal policy, especially if it benefits from a broad political support, as it would reduce the risk of seeing the debt reach the ceiling as has occurred in the past. In addition, the government needs to implement the multi-annual expenditure rule already planned in the constitution (Table 4). A similar framework has been quite successful in Israel. Combining a debt target with a spending rule would help control the size of the public sector, and therefore the tax burden, and allow the automatic stabilisers to work. Such a reform of the fiscal framework would be a better option than some recent proposals put forward in the public debate to address the need perceived by some of giving policy makers more room for potentially useful fiscal initiatives. One such proposals, which for instance aims at exempting investment spending from the current debt rule (Government, 2016), would weaken the fiscal framework’s transparency without addressing all key fiscal needs.

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Table 4. Past OECD recommendations on fiscal policy Recommendations in previous Surveys

Action taken since September 2014

Create enough room over time under the debt ceiling to allow automatic stabilisers to work.

Debt has been reduced in the last three years, and official plans call for further reduction, but it remains above some legal ceilings.

Implement the constitutional provision of multi-annual binding spending ceilings to reinforce budget discipline in upturns.

No action taken.

A more efficient public sector Increasing public-sector efficiency is a crucial policy challenge in Slovakia, as highlighted in the previous Survey. Transparent and efficient agency management is essential not only to ensure good public services and promote budgetary savings, but also to enhance public trust in policy-making. Pursuing reforms with these objectives is particularly important in education and health care, as discussed below. Tax evasion also remains substantial, undermining revenues and the system’s fairness. The shadow or non-observed economy estimated in the national accounts seems to be relatively large, at around 15% of GDP, as in the other central or Eastern-European countries (Gyomai and Van de Ven, 2014), and the under-reporting of incomes seems widespread (Machlica et al., 2014). Measures adopted by the authorities have considerably improved VAT revenues since 2012, but collection remains much less efficient than in other EU countries (Figure 13). The tax agency’s staffing level relative to the total labour force is high, partly reflecting low tax e-filing (OECD, 2015a). To address these deficiencies the government adopted further anti-fraud measures in 2015 (Table 5) and has recently launched a plan to enhance the IT infrastructure of the revenue authority. To make tax payments easier and rely more heavily on voluntary compliance, the government is working to facilitate filing electronically. Additional Action plan to fight tax evasion was adopted in 2017 with measures including better electronic communication, more efficient auditing and online monitoring of transactions. Further helpful measures would include: linking the IT systems of the tax

Figure 13. Efficiency of VAT collection1 40

2014

40

2012

30

30

20

20

10

10

0

FIN

SVN

ESP

EST

AUT

PRT

EU27

CZE

HUN

LVA

POL

ITA

GRC

SVK

0

1. Difference between the amount of VAT collected and the theoretical tax liability according to tax law as % of VAT total tax liability. Source: Center for Social and Economic Research (2016), “Study and Reports on the VAT Gap in the EU-28 Member States: 2016 Final Report”, TAXUD/2015/CC/131, August. 1 2 http://dx.doi.org/10.1787/888933500052

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27

ASSESSMENT AND RECOMMENDATIONS

Table 5. Past OECD recommendations on taxation Recommendations in previous Surveys

Action taken since September 2014

Further enhance the efficiency of tax administration. Continue efforts to improve tax collection.

In July 2015 the government updated its “Action Plan to Combat Tax Fraud” with 30 additional measures, including, for example, the introduction of criminal liability for firms evading taxes, several measures against excise duty evasion and the establishment of a register of risky taxpayers. Additional Action plan to fight tax evasion was adopted in 2017 with measures including better electronic communication, more efficient auditing and online monitoring of transactions.

Increase taxes on property and environmentally harmful activities.

No action taken.

administration with those of other institutions (the banks, for example); merging the tax/ customs office with the social security agency; further strengthening the tax administration’s analytical capacity (EC, 2016a); and improve enforcement of sanctions for tax evasion. Although the tax burden is low, the tax mix could be improved. The relatively heavy reliance on social security taxes increases the cost of employing low-wage workers, harming the least skilled (Figure 14, Panels A and B). The tax burden on labour was somewhat reduced in 2015 with the introduction of a health insurance contribution-free allowance. Recurrent real estate taxation is low, even though such taxes are the least distortive for economic

Figure 14. Taxes in the Slovak Republic A. Composition of tax revenue 2015

36

Other taxes Taxes on income and property Social contributions and payroll taxes

30

C. Property taxes 2015 or nearest year

GRC

FIN

SVK

AUT

SVN

SVK

POL

HUN

FIN

CHL

PRT

CZE

ESP

ISR

ESP

FIN

OECD¹

POL

GRC

PRT

CHL

0.0

HUN

1.5

0.0

AUT

3.0

0.6

ISR

6.0 4.5

SVN

PRT

7.5

1.2

CZE

HUN

9.0

1.8

SVK

CZE

D. Alcohol-attributable deaths % of population aged 15 and over, 2012

% of GDP 3.6 Taxes on transactions and other taxes 3.0 Wealth taxes (including inheritance taxes) 2.4 Recurrent taxes on immovable property

EST

ESP

0

Slovak OECD¹ Republic % of total tax revenue

GRC

Slovak OECD¹ Republic % of GDP

EST

6

0

POL

12

20

SVN

18

40

OECD¹

24

60

AUT

80

ISR

100

B. Tax wedge assessed at 67% of average wage² Single parent with two children, 2015

CHL

% 120

1. Unweighted average of data in 2015 or nearest year. 2. Measures the gap between total remuneration from work paid by the employer and net remuneration actually received by the employee, as a percentage of total remuneration from work. Source: OECD (2016), OECD Economic Outlook: Statistics and Projections (database); OECD Tax Statistics (database); OECD Taxing Wages Statistics (database); OECD Health Statistics (database); and F. Sassi (ed.) (2015), Tackling Harmful Alcohol Use: Economics and Public Health Policy, OECD Publishing, Paris. 1 2 http://dx.doi.org/10.1787/888933500071

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ASSESSMENT AND RECOMMENDATIONS

growth (Panel C; Johansson et al., 2008). Moreover, real estate taxes are now unfair, as the tax base does not reflect current market prices for property (OECD, 2014a; Harvan et al., 2015). The authorities have started to prepare to reform this local tax, but this will take several years given political and technical difficulties. Other possible sources of revenue include: inheritances, which are not taxed at all; capital gains on real estate, which are not taxed if the property is held for more than five years; environmental taxes, which would help reduce pollution and waste landfilling and their negative health impact (see below); and higher taxes on alcohol and sugary beverages, which would also improve health outcomes (Panel D). In this regard, the 2017 tax increase on cigarettes was a welcome step. The composition of Slovak public spending is markedly different than is typical in the OECD, with general services, public order and economic affairs accounting for large shares (Figure 15) (OECD, 2014a). An excessive number of local governments (almost 3 000) implies inefficient governance structure and excessive costs (National Reform Programme, 2017). Merging municipalities and reducing the number of administrative units could free up resources for new investment and services at the local level. Empirical estimates suggest that merging municipalities and reducing their number would free up between 0.1% and 0.4% of GDP (Cernenko, Harvan and Kubala, 2017). This suggests room for shifting the composition towards items such as education and integration that would boost inclusiveness and productivity (Mourougane et al., 2016). Such a development would be helped by an increased absorption capacity of EU structural funds. The gains from stronger public investment could be substantial, given the paucity of public capital (Fournier, 2016). The deficit in transport infrastructure is especially large (OECD, 2014a). Expenditure in this area is low for a catching-up country, and the quality of transport networks looks poor because of a lack of maintenance and repair (MoF, 2016b; Figure 16). This hampers mobility and hinders the reduction of regional disparities and growth, although Slovakia has vast opportunities in this dimension

Figure 15. Composition of general government spending 2015

B. Leading-European economies¹

A. Slovak Republic

Defence²

Defence²

General public services

General public services Social protection²

Economic affairs Economic affairs Education² Education² Environment protection²

Social protection²

Environment protection²

1. Leading-European economies are defined as the top five European economies in the OECD better life ranking: Netherlands, Denmark, Sweden, Norway and Switzerland. 2. Sectors based on the Classification of the Functions of Government 93 (COFOG) with the following aggregations: Defence includes public order and safety; Environment includes housing and community amenities; Education includes recreation, culture and religion; and Social protection includes health. Source: Eurostat (2017), Government Finance Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500090

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ASSESSMENT AND RECOMMENDATIONS

Figure 16. Public investment spending A. Total transport investment Average 2002-12

% of GDP 2.0

B. Perception of transport infrastructure quality² 2015

PRT

AUT

ESP

FIN

CHL

OECD¹

ISR

SVN

EST

GRC

CZE

HUN

SVK

ESP

SVN

EST

CZE

0.0

POL

0.0

HUN

1.4

GRC

0.4

ISR

2.8

SVK

0.8

PRT

4.2

OECD¹

1.2

AUT

5.6

FIN

1.6

POL

7.0

1. Unweighted average. 2. Index from the lowest perceived quality (0) to the highest (7). Source: OECD (2016), OECD Economic Outlook: Statistics and Projections (database); ITF-OECD (2016), “Transport Infrastructure” in Transport Statistics (database); and World Economic Forum (2015), The Global Competitiveness Report 2014-15. 1 2 http://dx.doi.org/10.1787/888933500109

(EC, 2016a). However, there is a large risk that such spending will not be very effective owing to major weaknesses in the public sector. Poor management efficiency in the public administration has reduced the quality of Slovak public investment (OECD, 2014a; Dutu and Sicari, 2016) (Figure 17). Relatively limited progress has been made so far in modernising it (Table 6). After the 2016 elections a full public expenditure review was launched on a four-year cycle with EC, IMF and OECD support. This initiative aims to develop a methodological toolbox and internal analytical capacity to do “Value-for-Money” analyses at the Ministry of Finance and line ministries. The first review in 2016 assessed government spending in ICT, transport and health, focusing on outcomes rather than inputs, which is welcome, even if it is too early to evaluate its impact. The second review in 2017 covers education, the environment and labour market and social policy. Reducing corruption is essential. In 2015 nearly 60% of entrepreneurs perceived corruption as a problem for doing business in the country, including for licensing and public procurement (Eurobarometer, 2015). The near-impunity of and often light sanctions meted out to those guilty of these practices, due to the deficiencies of the judicial system, encourage their persistence (EC, 2016a). The judicial system could be improved by strengthening its integrity and independence which are perceived as insufficient, and speeding up its procedures, which are long and costly (Figure 18) (EC, 2017; Palumbo et al., 2013). In the recent past the number of indictments for corruption-related offences has been low, and while most lead to convictions, the proportion of suspended sentences is high (EC, 2016a). Moreover, high-profile cases that reach the courts have remained rare (EC, 2016a). A more independent and transparent judicial system with adequate financial and technical means and dissuasive penalties against infractions would enhance public trust in the state and foster solid and inclusive growth (IMF, 2016b; Rigobon and Rodrik, 2005). The authorities have initiated reforms to address these shortcomings (Table 7), including recent anti-offshore legislation that requires firms participating in public tenders to

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ASSESSMENT AND RECOMMENDATIONS

Figure 17. Effectiveness of public administration Performance in government general services,1 scale from 0 to 6 (best)

FIN

NLD

CHE

NOR

DEU

SWE

LUX

GBR

DNK

ISL

JPN

BEL

AUT

IRL

FRA

ISR

EST

OECD²

USA

0

PRT

0

TUR

1

POL

1

SVN

2

ESP

2

CZE

3

HUN

3

ITA

4

KOR

4

SVK

5

GRC

5

1. Composite performance indicator for public administration outcome based on OECD’s Product Market Regulation (PMR) Indicator (for 2013) to proxy the levels of bureaucracy (33% of indicator) and results of the 2014 WEF survey on the quality of justice, level of corruption and government inefficiency (data for 2013). 2. Unweighted average of data shown. Source: Dutu, R. and P. Sicari (2016), “Public Spending Efficiency in the OECD: Benchmarking Health Care, Education and General Administration”, OECD Economics Department Working Papers, No. 1278, OECD Publishing, Paris. 1 2 http://dx.doi.org/10.1787/888933500128

Table 6. Past OECD recommendations on raising the efficiency of public spending Recommendations in previous Surveys

Action taken since September 2014

Establish better human resource management, modernise public administration, and strengthen co-ordination and collaboration across government. Widen the use of performance elements in promotion, contract renewals and compensation of public staff.

In October 2015 a comprehensive Strategy on Human Resource Management in the Civil Service (2015-2020) was adopted, resulting in new legislation. This reform, which should enter into force in June 2017, aims to depoliticise the professional staff, increase the transparency of civil servants’ recruitment and remuneration, and reduce their turnover. The reform of the local administration, launched in 2013 (the so-called ESO program), is currently in its third phase: one-stop shops are being established in the district offices to provide a wide variety of public services. At the beginning of 2017, 50 customer centres had so far opened out of the 79 planned.

Continue to increase resources for growth-enhancing areas such as education, research and development, and infrastructure. Establish an effective framework for assessing and selecting infrastructure projects, using tools such as cost-benefit analysis.

In 2015 infrastructure investments almost doubled compared to 2014 due to greater use of EU funds. The education budget is expected to rise over the next four years as a result of the planned uprating of teachers’ salaries by 6% per year.

Increase the scope for monitoring and evaluation of spending programmes. Establish a robust system of internal controls, and include appropriate performance and results information in annual budget documentation. Allocate more resources to ex post audits, and take the results into account in budget allocation.

A programme of spending reviews has begun to improve the efficiency and effectiveness of public spending. The authorities plan on a rolling series of policy and thematic reviews, with the aim of covering the whole of general government over the four-year parliament. Findings from the 2016 evaluation on ICT spending, health care and transport were used in the 2017 budget preparations. Priority is being given to develop a methodological toolbox and internal analytical capacity to do value-for-money analysis at the Finance and line ministries, drawing lessons from international experience with the help of the EC, IMF and OECD on design and methodological matters.

disclose their full ultimate ownership structure. A Memorandum of Understanding was signed between the Slovak Republic and the OECD in January 2017 to deepen co-operation in order to increase transparency and counter corruption. As the first step under this OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

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ASSESSMENT AND RECOMMENDATIONS

Figure 18. Perception of the effectiveness of judicial system Scale from 0 to 10 (greatest economic freedom), 2014

A. Integrity of the legal system¹

FIN

ISR

EST

AUT

OECD²

CHL

PRT

CZE

POL

GRC

ESP

HUN

SVK

FIN

AUT

CZE

ISR

0

ESP

0

PRT

2

OECD²

2

CHL

4

SVN

4

POL

6

GRC

6

SVK

8

HUN

8

EST

10

SVN

B. Judicial independence¹

10

1. It is one of the nine components in the area, “legal system and property rights”, for the Economic Freedom of the World index which measures the degree of economic freedom present in five major areas: size of government, legal system and security of property rights, sound money, freedom to trade internationally, regulation. 2. Unweighted average of data shown. Source: Fraser Institute, Economic Freedom of the World (EFW) index (www.freetheworld.com). 1 2 http://dx.doi.org/10.1787/888933500147

Table 7. Past OECD recommendations on improving the judicial system and fighting corruption Recommendations in previous Surveys

Action taken since September 2014

Strengthen the efficiency and independence of the judicial system. Increase judicial capacity in particular through investment in IT systems.

The Slovak Civil Procedural Law was re-codified with effect from July 2016. Proposed legislation aims to increase enforcement of the law and reduce delays in court proceedings. Several IT projects were implemented or are ongoing, including the development of electronic judicial services, court files, insolvency and disqualification registers. At end-2015 a Code of ethics for judges was adopted. In March 2017, changes in the process of judicial restructuring improved insolvency procedures by reducing the scope for debt forgiveness, unless the creditor voluntarily agrees. In November 2016, new rules were adopted for distraint proceedings to improve procedures for enforcing liabilities.

Fully enforce the provisions of the laws fighting corruption. Ensure that public procurement achieves the best value for money, and continue with measures fighting corruption, inter alia by guaranteeing greater transparency.

The National Anti-Corruption Unit has elaborated an internal “Methodology of detection and investigation of the corruption and related criminal offences”, which has been in use since January 2015. In early 2015 a new law entered into force to protect whistle-blowers. An Action Plan against corruption was also approved by the government in July 2015. Since November 2015 a new public procurement law has put increasing focus on procurement preparation, use of quality criteria and life-cycle costing. Since January 2017 new anti-offshore legislation requires firms to disclose their full ultimate ownership structure.

initiative, the Government Office invited the OECD to conduct an “Auditing and integrityrisk mapping of the anti-corruption related legislation”. To this end, the OECD reviews selected anti-corruption related laws concerning whistle-blower protection, the execution of public duties, audit and inspection in the public service. The resulting assessment of these laws and proposals for action will provide the Government of Slovakia options for

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ASSESSMENT AND RECOMMENDATIONS

closing the legal loopholes and good practices for strengthening integrity in the public sector. The assessment will also identify priority areas which should be further investigated in the second phase of this co-operation project.

Further enhancing the business environment in the non-tradable sectors Productivity developments in the non-tradable sectors over the last two decades have been lagging those of Slovakia’s central European neighbours, reflecting its dual economy (Figure 19, Panels A and B). Local services producers appear to have benefited little from the manufacturing sector’s integration into global value chains. Despite remarkable progress in improving product market regulation since 2008, too little ex post regulatory evaluation is undertaken, and several services sectors still face substantial entrepreneurship barriers (Table 8). These affect professional services, including legal services, architects and engineers, where foreign competition is more limited than in the average OECD country (OECD, 2015b; EC, 2017) (Panel C). All the shares in law firms must, for instance, be owned by locally licensed lawyers, and their boards must comprise locally licensed lawyers. In architecture and engineering services the Slovak Republic imposes residency and nationality requirements as preconditions for obtaining a license to practice. Moreover, the substantial involvement of the state in many network industries, despite the 2015 privatisation of Slovak Telecom, seems to have negative effects on their services.

Figure 19. The business environment A. Labour productivity for manufacturing Index 1995 = 100

0.1

0.03 Architecture

Engineering

Legal

0.00

2013

2009

2007

2005

2003

1999

2015 SVK

0.06

POL

0.09

0.2

HUN

0.3

PRT

0.12

GRC

0.15

0.4

ESP

0.5

0.0

1997

EUR (PPP)/kWh 0.18

CZE

OECD minimum

EU28

OECD average

AUT

Total

Austria Hungary

D. Electricity prices for industry² 500 MWh < consumption < 2 000 MWh, 2015

FIN

C. Services Trade Restrictiveness Index¹ Scale from 0 to 1 (most restrictive), 2016

2015

2013

2011

2009

2007

2005

2003

60

2001

0

1999

90 1997

120

100 1995

150

200

1995

180

300

0.6

Slovak Republic Czech Republic Slovenia

210

2011

240

2001

400

Austria Hungary

EST

Slovak Republic Czech Republic Slovenia

500

SVN

600

B. Labour productivity for business services sectors excluding real estate Index 1995 = 100

1. They are calculated on the basis of the Service Trade Restrictiveness Index (STRI) regulatory database. The STRI database records measures on a most-favoured-nation basis. Preferential trade agreements are not taken into account. 2. Prices excluding taxes and levies. Source: OECD (2017), OECD Productivity Statistics (database); “Service Trade Restrictions Index by services sector” in OECD Industry and Services Statistics (database); and Eurostat (2017), Energy Price Statistics. 1 2 http://dx.doi.org/10.1787/888933500166

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ASSESSMENT AND RECOMMENDATIONS

Table 8. Past OECD recommendations on product market reforms Recommendations in previous Surveys

Action taken since September 2014

Ease regulation in professional services and retail trade.

No action taken.

Reduce bureaucratic costs, and make regulations more business-friendly. Establish a timetable for measures aimed at tackling business barriers. Strengthen regulatory impact assessment.

Since 2015 the administrative costs of information submission obligations has been measured yearly to reduce business administrative burdens on the basis of discussions with entrepreneurs and international reports on the business environment. In August 2015, for instance, a new legal form of firm (a simplified joint-stock company) was introduced to ease business start-ups and allow more flexible relations among shareholders. A unified methodology for regulatory impact assessment took effect in October 2015. It requires, among other things, consultations with stakeholders prior to the elaboration of regulations.

Strengthen competition in network industries. Ensure that price regulation does not deter the entry of new competitors in the energy market. Strengthen the independence of the telecommunications regulator.

Price regulation under the Network Industries Act has been aligned with EU legislation. The Regulatory Office for Network Industries sets maximum prices that take into account all costs and adequate profits in the regulated segment of delivery to vulnerable users.

Privatise the remaining government shares in the telecommunications In 2015 the government’s 49% stake in Slovak Telecom was sold. incumbent. Pursue further entry of private capital in electricity generation and distribution and gas distribution sectors.

Electricity, gas and mobile telecommunication prices are high for businesses (OECD, 2015c; Eurostat, 2017) (Panel D). Competition in the electricity sector is relatively weak due to a complex and opaque regulatory framework, which creates hurdles to new production and cross-border transmission and does not encourage productivity gains nor lower prices (EC, 2017). Moreover, end-user electricity prices are increased by costs not directly connected with production, transmission and distribution of electricity, including supporting domestic brown coal mining (by regulations that require producers to purchase such inputs at abovemarket prices), with resulting harmful impacts both on the economy and the environment. The subsidy for brown coal prices paid by consumers will amount to [euro] 95.4 million in 2017 or 3.5% of the average final electricity price for households. The duality of the Slovak economy is also reflected in the performance of its entrepreneurs and SMEs, which are most often operating in traditional non-tradable sectors. Slovakia’s firm structure is dominated by SMEs, many of which suffer from low innovative activity and weak productivity. Yet, SMEs can play an active role in achieving stronger and more inclusive growth since they employ more than 70% of workers (OECD, 2016b). This requires cutting the productivity gap between the mostly large firms at the technological frontier and SMEs (Saia et al., 2015). New legislation promoting better structured and simpler SME support schemes, including for administrative procedures, entered into force in 2017 (EC, 2017). This move is welcome, as long as it is well targeted and does not support nonviable firms, but it should be accompanied by better SME access to finance, which is one of the keys to unlocking SMEs’ potential to innovate and become more productive. Access to finance by Slovak SMEs, which are over-reliant on bank credit, is particularly difficult: interest spreads on loans are relatively wide compared with their larger counterparts, loan rejections are common, and access to venture capital is poor (OECD, 2016c).

Improving labour market performance Reforms are needed to make growth much more inclusive by widening the opportunity for women and disadvantaged groups to enhance and realise their potential in the labour market. This entails a search for removable barriers to employment. Despite recent improvements, employment rates remain below the OECD average, especially in the case

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ASSESSMENT AND RECOMMENDATIONS

of women with small children (Figure 20) and disadvantaged groups, particularly Roma. The long-term unemployment rate is also high, and there are wide regional disparities in labour market outcomes.

Figure 20. Mothers with young children tend to withdraw from the labour market Employment rates (%) for women with children by age of the youngest child, 2014

Employment rate % 100 Youngest child aged 0-2

90

Youngest child aged 3-5

Youngest child aged 6-14

80 70 60 50 40 30 20

HUN

SVK

TUR

EST

CZE

CHL

MEX

NZL

JPN

DEU

GRC

FIN

OECD*

EU

ITA

POL

USA

FRA

GBR

IRL

ESP

BEL

AUT

ISR

CAN

LUX

CHE

SVN

PRT

NLD

0

DNK

10

Note: OECD comprises 29 member countries. Source: OECD Family Database (2017). 1 2 http://dx.doi.org/10.1787/888933500185

Encouraging women to join the labour market Mothers with young children typically stay out of the labour market for long periods of time: Slovakia has one of the longest parental leaves in the OECD, mostly taken by mothers (Figure 21, Panel A). But, more importantly, a lack of childcare facilities tends to discourage

Figure 21. Mothers with small children face incentives to work

75

120.0

60

90.0

45

60.0

30

30.0

15

0.0

0

EST FIN HUN SVK CZE KOR AUT DEU SWE OECD SVN CAN DNK POL ITA FRA PRT BEL ISL AUS

150.0

B. Share of 0-2 year olds in formal childcare and pre-school services¹ 2014

DNK ISL NLD BEL FRA PRT SWE SVN OECD DEU FIN ITA EST CHL AUT HUN GRC SVK CZE

A. Weeks of paid parental leave, 2016

1. Data reflect children in day-care centres and pre-school (both public and private) and those who are cared for by liscensed childminders. It excludes informal services provided by relatives, friends or neighbours regardless of whether or not the service is paid for. Source: OECD Family Database (2017). 1 2 http://dx.doi.org/10.1787/888933500204

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35

ASSESSMENT AND RECOMMENDATIONS

mothers with small children from looking for jobs. Facilities for children under three are scarce, and only 3% of small children attend nurseries, compared to over 30% in the average OECD country (Panel B). As a result young families are often faced with a choice between employment and home child care. Extended periods of absence from the labour market tend to deteriorate their human capital leading to poor career prospects. Reducing the length of parental leave would be politically difficult for cultural reasons, but to favour better gender balance of paid and unpaid work and encourage women to return to the labour market, a part of parental leave should be available for fathers only. A similar reform in Iceland increased the proportion of parental leave taken by fathers from 3% to around 35% (OECD, 2011a). Moreover, increasing the father’s role in childcare is also associated with rising fertility rates and better child development later in life (Feyrer et al., 2008; Cools et al., 2015). For such a policy to have its greatest effect, early childcare facilities need to be expanded at a much faster pace. One way for mothers to get into the labour force could be part-time work, which is little used in Slovakia (3% of employees work part-time, against 20% in the OECD overall). Increasing part-time work in the public sector could provide an example for the private sector.

Reducing long-term unemployment The other main challenge for the labour market is the integration of the long-term unemployed and the low-skilled into employment. Despite increasing employment, more than 60% of the unemployed have been out of work for more than a year, and the mean duration of unemployment is around 30 months, the highest in the OECD (Figure 22).

Figure 22. Long-term unemployment is high Average duration of unemployment in months, 2015

Months 40

Months 40

30

30

20

20

10

10

0

CAN

NOR

USA

OECD

FIN

CHE

HUN

CZE

SVK

0

Source: OECD (2017), OECD Employment and Labour Market Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500223

Spending on active labour market policies (ALMPs; for example, training and job search) is low by OECD standards (Figure 23, Panel A), and does not involve very much training, even though experience from other countries shows that training can be effective (Card et al., 2015). By contrast, public work schemes (so called activation works), which are heavily used in Slovakia for the low-skilled and long-term unemployed, have failed to improve their job

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Figure 23. Low spending in active labour market policies A. Relatively little is spent on active labour market programmes per unemployed person As a % of GDP per capita, 2013

B. Share of participants in active labour market programmes % of labour force, 2014 %

% 60

50

50

40

40

Slovak Republic

OECD

30

30 20

20

10

0

0

DNK SWE NOR AUT FIN DEU CHE NLD FRA LUX BEL HUN OECD NZL CZE AUS ITA CAN PRT SVK

10

Training

Direct job creation

Start-up Employment Sheltered & incentives incentives supported employment

Source: OECD (2017), OECD Employment and Labour Market Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500242

prospects (Hidas et al., 2016). This confirms other countries’ experience that shows that participation in such schemes can lower the probability of finding employment after the programmes have ended, reflecting lock-in effects that prevent enrolees from job search or training activities (Card et al., 2015; Duell et al., 2010). Therefore, in line with recommendations in previous Surveys, training measures should be strengthened and job-creation programmes proposed only when no other options are available (OECD, 2012) (Table 9). The second valuefor-money cycle focusing on labour-market-related spending provides an opportunity to implement such changes and to raise the effectiveness of ALMPs.

Table 9. Past OECD recommendations on the labour market Recommendations in previous Surveys

Action taken since September 2014

Develop training as well as job-search support, and phase out public-works programmes.

As of October 2014 a new programme in the field of education and preparation for the labour market was introduced, which individualises requalification training. Changes to the Act on employment services effective 1 January 2016 and 1 May 2017 aim to improve the access of jobseekers to training and widen the range of available measures.

Implement systematic evaluations of ALMPs, and increase spending on programmes with demonstrated effectiveness. Continue to test new programmes with pilot projects before implementation at the national level.

A spending review of ALMPs was conducted at end-2016 and early-2017. The results have been published, but changes have not yet been implemented. An action plan to strengthen the integration of long-term unemployed in the labour market was published in early 2017.

Enhancing Roma integration Roma have long been a particularly vulnerable and poorly integrated group. Their employment rate is only 25%, and they suffer heavily from long-term unemployment. Their labour market outcomes are much weaker not only compared to the general population, but also compared to Roma in neighbouring countries (Figure 24). These difficulties stem from inadequate education, a poor social environment and widespread discrimination

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ASSESSMENT AND RECOMMENDATIONS

Figure 24. Roma’s employment is low 2015

% 80

% 80

60

60

40

40

20

20

0

Overall population

Roma Slovak Republic

Roma Hungary

Roma Czech Republic

0

Source: EU (2016), Second European Union Minorities and Discrimination Survey, Roma – Selected findings, European Union, Agency for Fundamental Rights. 1 2 http://dx.doi.org/10.1787/888933500261

(Bartoš et al., 2014; Machlica et al., 2014). Roma live predominantly in rural areas, many do not speak Slovak, and their children usually do not attend pre-school (Gatti et al., 2016; UNDP, 2012). Moreover, Roma youth are overrepresented in special schools, which are designed for children with disabilities, although an initiative was launched in 2015 to prevent misdiagnosis of Roma students and their subsequent assignment to special schools (Chapter 1). Addressing this social challenge requires a multi-faceted approach in view of the complexity and persistence of their under performance. The government has recognised the need for better integration of the Roma to give them a feeling of belonging to society and to save on future social welfare spending. In 2012 a strategy was put in place to this end, covering employment, education, health care and housing. In view of the limited progress made so far, the government has recently developed a more specific and detailed action plan and increased funding by 0.4% of GDP for the period 2016-18 (Ministry of Interior, 2017). Further efforts will probably be needed, including targeted labour market policies, high-quality education (Chapter 1), and increased enrolment of Roma children in pre-school (Roma enrolment rates are only half those of the general population). Indeed, following the example of several other EU member countries, such as Bulgaria, Poland, Romania and Hungary, obligatory pre-school education would be desirable. Hungary, with compulsory enrolment from the age of three, has almost the same enrolment rate in kindergartens for its Roma and non-Roma children. In any case, conditional cash transfers (CCTs) could improve pre-school attendance for children from poorer households following the Brazilian example. Empirical evaluations of CCT programmes and field experiments have shown positive effects on school attendance (EC, 2014a). For example, such a programme was introduced in Hungary in 2009, aiming to increase kindergarten enrolment of disadvantaged children aged 3 and 4. This led to much higher enrolment (Kertesi and Kézdi, 2013). Finally, statistics on the Roma are poor and unreliable, and better data would improve the design and evaluation of programmes for them (EC, 2016b).

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Promoting a deeper rental housing market to improve workers’ mobility and reduce regional imbalances Regional inequalities are among the highest among OECD countries, with sharp differences between the per capita GDP in Bratislava and the rest of the western part of the country and the lagging central and eastern regions (Figure 25). This issue was discussed extensively in the 2014 Survey (OECD, 2014a), and the main manifestation of regional imbalances was found in sharp differences in labour market performance (Figure 26, Panel A). In response to this situation, in 2016 the authorities adopted a set of action plans covering the period to 2020 to support 12 out of the 79 districts that are most affected by high unemployment. It aims to support growth and employment in these regions with particular attention to marginalised Roma communities by improving municipal infrastructure,

Figure 25. Regional economic inequalities A. Gini index of inequality of GDP per capita across regions¹, 2013 SVK HUN EST POL OECD² AUT CZE PRT SVN ESP FIN GRC 0.00

0.05

0.10

0.15

0.20

0.25

0.30

1. The Gini coefficient is calculated for GDP per capita across regions with equal weight to each region regardless of its size, and it has a range from zero (no disparity) to one. Increasing values of the Gini coefficient thus indicate higher inequality in regions. 2. Unweighted average. Source: OECD (2016), OECD Regions at a Glance 2016. 1 2 http://dx.doi.org/10.1787/888933500280

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ASSESSMENT AND RECOMMENDATIONS

Figure 26. Regional mobility and housing indicators A. Regional disparities in long-term unemployment rate % of labour force 2014 or nearest year 30

Minimum

Country average

B. Annual regional migration rate % of population, average 2011-13 HUN ISR FIN SVN OECD SWE AUT GRC ESP EST CZE POL SVK

Maximum

24 18 12

% of total housing 50

ESP

SVK

POL

CZE

HUN

GRC

ISR

PRT

SVN

CHL

FIN

AUT

0

EST

6

20

AUT

EU28

FIN

PRT

GRC

SVN

CZE

ESP

EST

POL

10 HUN

2

3

4

5

NOR EST IRL SVK CZE POL PRT ESP ISR HUN LVA

30

SVK

1

D. Public spending on support for homeownership¹ Central government spending as % of GDP, 2012-2013

C. Share of tenants 2015

40

0

0

0.00

0.06

0.12

0.18

0.24

0.30

1. Data are based on OECD Questionnaire on Affordable and Social Housing 2014 except for the Slovakia data coming from the paper of P. Harvan et al., (2016). For Spain, spending data for some policy instruments are missing and the reported amount is a lower-bound estimate. Source: OECD (2016), OECD Economic Outlook: Statistics and Projections (database); OECD Tax Statistics (database); OECD (2016), OECD Regions at a Glance 2016; A. Salvi del Pero, W. Adema, V. Ferraro and V. Frey, “Policies to promote access to good-quality affordable housing in OECD countries”, OECD Social, Employment and Migration Working Papers, No. 176, OECD Publishing; Harvan, P., A. Jev ák, P. Pont’uch and V. Solani , “The Impact of Rapid Credit Growth on Slovakia’s Housing Market”, Economic Brief 006, European Commission, December. 1 2 http://dx.doi.org/10.1787/888933500299

adopting specific training measures for youth and promoting entrepreneurship and the comparative advantages of these districts. One reason for these labour market disparities is very low worker mobility, which is related to the lack of rental housing (Andrews et al., 2011) (Figure 26, Panel B). Rentals accounted for less than 10% of the property market in 2013 (Panel C). Lack of rental accommodation makes it financially very difficult for those in lagging regions to seize employment opportunities elsewhere. As recommended in the previous Survey, developing the rental sector would improve inter-regional mobility and access to employment (Table 10). This would be particularly beneficial for young people (25-34), who cannot afford to buy a dwelling (Harvan et al., 2015).

Table 10. Past OECD recommendations on the housing sector Recommendations in previous Surveys

Action taken since September 2014

To develop the rental housing market, phase out support to home Loan conditions available to municipalities to develop social rental ownership, and expand means-tested rental housing allowances. housing have become more favourable since January 2016. Suppress grants allocated to youth for housing purchases, the state bonus on saving devoted to housing purchase and mortgage subsidies. Allow more flexibility for rental contracts, and develop the use of extendible fixed-term contracts.

40

No action taken.

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Reducing financial incentives for homeownership and introducing a more balanced regulation of landlord-tenant rights would deepen the rental sector. This would involve reorienting current housing subsidies for homeownership (Figure 26, Panel D) to rental housing by introducing, for instance, a means-tested allowance for young people. Current rental regulations favour short-term rentals (up to two years), which do not offer a genuine alternative to ownership, while existing indefinite contracts protect tenants excessively against the risks of eviction, even if they do not pay their rent, which discourages rental supply (Vagac, 2013; Harvan et al., 2015). Reform of the Slovak rental market seems warranted and has been recommended in past Surveys. The introduction of regulations making medium-term renting a more reliable housing option would foster the development of a broader, more stable private rental housing market. In this sense, increasing minimum contract duration beyond two years and limiting the right of landlords to evict their tenants to only specific reasons (e.g. if the tenant fails to pay the rent or if the landlord wants to sell the dwelling or occupy it) would go in the right direction. Introducing a ceiling for the maximum annual increase of rents during the term of the lease would also increase the predictability of rents, but runs the risk of, over time, keeping rents too low and thereby constraining the supply of rental dwellings. Linking rent increases to economic conditions and allowing landlords to reset rents for new tenants would alleviate this problem. Relatively rapid legal eviction procedures for non-payment of rents or destruction of property would also probably help to ease potential bottlenecks of rental housing supply.

Enhancing skills to better meet labour market demand and foster inclusive productivity Slovakia’s educational outcomes are below the OECD average, and the education system does not prepare young people well for changes in the labour market. PISA outcomes for 15 year-olds are weak in international comparison and have deteriorated over time (Figure 27, Panel A). Similarly, skills of young people are falling behind, and their literacy results are lower than for average OECD youth and significantly worse than the best OECD performers (Panel B). Moreover, many people have very poor problem-solving skills and are not ready to use new information and communication technologies (ICTs). One quarter of the adult population is fully computer illiterate (PIAAC – National report, 2013), which is problematic given the growing importance of IT skills linked to the development of the digital economy. Highly qualified and motivated teachers are the key to strong learning outcomes (Chetty et al., 2014). But Slovakian teachers are poorly paid, even in relation to other salaries (Figure 28), and only 4% of them reported that their profession is valued in society (OECD, 2013b). The government has recognised the problem and has increased teachers’ salaries by 5% annually in the four years ending in 2015 and 10% in two steps in 2016. The government committed to raise teacher salaries by 6% per year on the average between 2016 and 2020 conditional on further structural reforms to boost quality of education (Table 11). While pay is not the only factor determining teacher quality, still further increases will be needed to attract good students to the profession. Making these or even faster pay increases conditional on improved teaching quality with a view to target the disadvantaged children would be beneficial. More teachers should engage in professional development (currently fewer than three in four do so annually), and its quality also needs to be raised. In other OECD countries managed professional development, with teachers

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ASSESSMENT AND RECOMMENDATIONS

Figure 27. Adult skills in literacy and problem solving A. Students’ education outcomes are weak and deteriorating Average of mean score in science, reading and mathematics 510

B. Relationship between literacy proficiency and age Trend scores by age, foreign-born adults excluded 315

OECD

Slovak Republic

500

300

490

285

480

270

470

255

Slovak Republic Highest-performing economies¹

460

2006

2009

2012

240

2015

OECD

15

20

25

30

35

40

45

50

55

60

65

1. Unweighted average of Australia, Finland, Japan, New Zealand and Netherlands. Source: OECD (2016), Skills Matter: Further Results from the Survey of Adult Skills; OECD (2013), OECD Skills Outlook 2013: First Results from the Survey of Adult Skills; OECD (2016), PISA 2015 Results (Volume I): Excellence and Equity in Education. 1 2 http://dx.doi.org/10.1787/888933500318

Figure 28. Teachers are amongst the lowest paid in the OECD Ratio of average teachers’ salaries1 to the wages of workers aged 25-64 with tertiary education, 2014

LUX

GRC

ISR

FIN

DEU

GBR (ENG)

FRA

BEL (Fl.)

EST

SVN

0.0

DNK

0.0

NZL

0.2 AUT

0.2 NLD

0.4

AUT

0.4

BEL (Fr.)

0.6

SWE

0.6

POL

0.8

CHE

0.8

HUN

1.0

NOR

1.0

ITA

1.2

USA

1.2

SVK

1.4

CZE

1.4

1. Salaries of lower secondary teachers for general programmes in public institutions including bonuses and allowances. Source: OECD (2016), Education at a Glance 2016: OECD Indicators. 1 2 http://dx.doi.org/10.1787/888933500337

receiving precise instruction together with specific, regular feedback under the mentorship of a lead teacher, has had large positive effects (Fryer, 2016). Teaching quality could also be enhanced by using more ICT. Education attainment in the Slovak Republic is comparatively high, as almost twothirds of adults have at least upper secondary education (compared to the OECD average of 40%), However, education policy should provide special support for students coming from disadvantaged backgrounds, particularly the Roma, as student background is a particularly important factor in student achievement in Slovakia (OECD, 2016d). Roma students’

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Table 11. Past OECD recommendations on education Recommendations in previous Surveys

Action taken since September 2014

Increase the wages of teachers, and take structural measures to increase the efficiency of the system. Improve the use of available evaluations to identify dysfunctional schools as well as best practices.

The teachers’ salaries increased by 5% annually in the four years ending in 2015 and 10% in two steps in 2016. The government committed to raise teacher salaries by 6% per year on the average between 2016 and 2020 conditional on further structural reforms to boost quality of education.

Develop the provision and quality of early childhood education, and ensure wide access to children from low socio-economic backgrounds, especially Roma children.

In 2015 the government increased the funding for kindergartens, allowing more than 5 000 new kindergarten places to be created. Extension of pre-school capacity will be supported in the municipalities with the highest segregation.

Strengthen incentives for the integration of pupils with special needs in the standard system. Raise support to disadvantaged pupils. Further encourage participation of children from low-income families and Roma in pre-primary education and the integration of Roma in mainstream education.

Around 890 new teaching assistants for children with disabilities have been hired. In 2015 a law was approved to better control the diagnosis of students with special needs and prevent the misplacement of Roma children in special schools or classes for financial reasons. New action plans for integration of Roma were adopted in early 2017.

Make tertiary education more attractive to technical secondary school graduates: develop short (2-3 year) occupationally oriented programmes. Introduce tuition fees coupled with income-contingent repayments. Facilitate entry of new institutions. Make budgetary allocations to universities more dependent on outcomes.

No action taken. Accreditation standards for new occupationally oriented programmes are currently being developed.

Enhance incentives for employers to allocate more resources and time to training. Pursue initiatives aiming at easing the recognition of non-formal education. Establish training vouchers to boost participation in lifelong learning.

Discussions are currently taking place between working groups on the new law on lifelong learning about the design of training vouchers.

outcomes are significantly worse than those of the non-Roma population (Figure 29). Therefore, the incentives for qualified and experienced teachers to teach in disadvantaged regions should be strengthened by introducing special allowances or in-kind support. At the same time, poorly performing students should receive teaching adapted to their abilities and needs by increasing the number of teaching assistants, particularly those who can speak Roma. Along with more R&D (which remains at only around 1% of GDP), tertiary education changes could also move Slovakia up the global value chain and stimulate productivity growth in an increasingly knowledge-driven global economy. Slovak tertiary institutions fail to prepare enough high-skilled workers for the needs of the labour market (Figure 30). The quality of tertiary education is among the weakest of Member countries, according to available international assessment (U21, 2016). Moreover, this quality is low even in regional comparison. Neighbouring countries have many more institutions among top universities in international rankings than Slovakia, and a growing number of talented Slovak students choose to study abroad (see below). The share of these students is one of the highest in the OECD, with most of them studying in the Czech Republic, as Czech tertiary institutions offer a better education according to a majority (82%) of them (Koucky, 2015). There is substantial scope to raise the quality of university research. It produces a large volume of publications, but relatively few researchers are able to produce citable publications that could be considered as excellent (Figure 31). While funding for tertiary education is partly based on performance in research, assessment does not make a clear distinction between higher- and lower-quality research (Ministry of Education, 2016). To promote higherquality research the transparency and autonomy of the Accreditation Committee, responsible for quality assurance, should be strengthened (EC, 2015b). This Committee

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ASSESSMENT AND RECOMMENDATIONS

Figure 29. Roma student performance is weak Average PISA scores in mathematics and reading, 2015

550

500

500

450

450

400

400

350

350

300

300

SVK- Roma¹ MEX TUR CHL GRC HUN ISR SVK -Slovak¹ LUX USA ISL LVA ITA CZE AUT ESP OECD PRT GBR FRA SWE AUS NZL BEL POL DNK CHE DEU NLD NOR SVN IRL FIN EST KOR CAN JPN

550

1. Each group is based on the same language spoken at home. Source: OECD (2016), PISA 2015 Results (Volume I): Excellence and Equity in Education; and OECD calculations based on PISA 2015 Database. 1 2 http://dx.doi.org/10.1787/888933500356

Figure 30. A low proportion of young adults have high-level literacy skills Percentage of adults aged 24-35 scoring at PIAAC literacy proficiency level 4 or 5, 2012

FIN

JPN

NLD

SWE

BEL²

NOR

AUS

CAN

OECD

GBR¹

DNK

EST

DEU

0

USA

0

CZE

8

POL

8

KOR

16

FRA

16

AUT

24

IRL

24

RUS

32

SVK

32

ESP

40

ITA

40

1. England and Northern Ireland only. 2. Flanders only. Source: Haugh, D., Y. Jin and A. González Pandiella (2016), “Growing together: Towards a more inclusive Ireland”, OECD Economics Department Working Papers, No. 1293. 1 2 http://dx.doi.org/10.1787/888933500375

should be independent of the Ministry of Education, and its members should not have any relations with any institution they assess (ENQA, 2013). In addition, funding should favour internationally recognised research outputs. Another major challenge for Slovakia’s tertiary education system is to strengthen its links with the labour market. Transfers of knowledge and collaboration with the labour

44

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Figure 31. Slovak researchers produce many publications, but their average quality is poor Number of documents and percentage among world’s 10% most cited, average 2003-12

A. Number of publications per GERD¹

GRC

CHL SVK

POL

SVN NZL

CZE EST

HUN PRT

TUR GBR

IRL ESP

ITA NLD

CAN

0

CHE AUS

0

NOR BEL

2

DNK ISL

2

FIN SWE

4

ISR MEX

4

FRA

6

DEU AUT

6

KOR USA

8

JPN LUX

8

B. Percentage of top publications per 1000 researchers

CHE

ITA CHL

NLD

NZL GRC

BEL IRL

AUS SVN

SWE GBR

CAN NOR

CZE

TUR ESP

0

DNK AUT

0

HUN POL

3 DEU USA

3 EST FRA

6

PRT ISL

6

MEX

9

SVK FIN

9

ISR LUX

12

JPN KOR

12

1. Gross domestic expenditure on R&D in million constant USD (constant prices and PPPs). Source: OECD (2016), OECD Science, Technology and R&D Statistics (database); OECD (2015), OECD Science, Technology and Industry Scoreboard 2015: Innovation for growth and society; and Scimago, J.R. (www.scimagojr.com). 1 2 http://dx.doi.org/10.1787/888933500394

market are among the weakest in the OECD (WEF, 2016). A majority of students have academicoriented studies and lack work experience, which slows skills acquisition. Only one-third of tertiary students gain some work experience during their studies, one of the lowest shares in the OECD. Moreover, most of these students work in areas outside their field of study, and skills mismatch is higher than in other OECD countries (Figure 32). In most OECD countries the business sector participates more actively in the governance and teaching process than in Slovakia, particularly in the case of tertiary vocational schools. Boosting the co-operation between firms and schools could be achieved by introducing short (three-year) professionally oriented bachelor programmes. As well, authorities should consider linking funding to labour market outcomes. Schools that co-operate with the private sector in research or practical training could be financially rewarded. In some countries institutions receive a sizeable share of public funds through developmental programmes attached to specific policy objectives (OECD, 2008a). Students could also be incentivised to work in related fields alongside their studies to gain practical skills. Schools should be encouraged, for example, to increase academic credits for participation in work-based learning. Another way to increase the supply of skilled workers is to attract foreign workers. However, the Slovak Republic now has the opposite problem: emigration of young talented workers. To a large extent, this reflects significant wage differentials, which ultimately can be corrected only through the long process of raising Slovakian productivity and, therefore,

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ASSESSMENT AND RECOMMENDATIONS

Figure 32. Qualification and education mismatches among young tertiary educated graduates are high Less than 35 year-olds

70

70 Field of study mismatches

Qualification mismatches

Both qualification and field of study mismatches

60

60

50

50

40

40

30

30

20

20

10

10

0

NLD

NOR

DNK

ESP

BEL

FRA

ITA

KOR

POL

CZE

SVK

GBR

JPN

RUS

0

Source: OECD (2012), The Survey of Adult Skills (PIAAC). 1 2 http://dx.doi.org/10.1787/888933500413

real wages. Nevertheless, the government should target skilled Slovaks working abroad, as return migrants can bring back skills, networks and financial capital, which can help spur innovation and growth (OECD, 2008b). Currently, there are two government schemes to attract return migrants, but their impact has been limited so far (see Chapter 1). The authorities should scale up these schemes and enhance their effectiveness, targeting especially skilled workers. In addition, the government should develop a comprehensive strategy to maintain ties with the large expatriate community. An information system should be set up to connect with the diaspora abroad and facilitate its engagement. The system should target and address emigrants soon after emigration, as the probability of return decreases after five years of living abroad (Pungas et al., 2012). Immigration laws should be eased to attract more skilled workers. Given the Slovak Republic’s membership in the European Economic Area (EEA), the scope for attracting skilled migrants is restricted for those from outside the EEA. However, these potential immigrants could be deterred by some of the strict features of Slovak immigration laws. The conditions for attributing Blue Cards, which grant special residency rights and work permits to highlyskilled migrants outside of Europe, are stricter than in other EU countries, and the public service allows only EU citizens to apply for a job (see Chapter 1). A recent initiative, currently being discussed in the parliament, aims to ease these regulations for non-EU workers. This is a welcome step and should ensure that it brings such laws and rules close to best practices (OECD, 2014b). Also, the government should step up efforts to attract international students, who can have a positive impact on the supply of skilled workers, as, on average, one-third of international students decide to remain in the host country after graduation (OECD, 2011b). However, Slovak tertiary education attracts fewer international students than other OECD countries (Figure 33). Therefore, the government should increase the provision of tertiary education programmes in foreign languages and strengthen scholarship programmes for talented foreign students.

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Figure 33. Many Slovak students study abroad and only few foreigners study in the Slovak Republic Percentage of total tertiary students, 20141

A. International or foreign student² enrolments in tertiary education

43.9

20

20

B. National tertiary students enrolled abroad

NZL

LUX

AUS

CHE

GBR

BEL

AUT

NLD

FRA

DNK

CZE

FIN

CAN

DEU

HUN

IRL

OECD

SVK

SWE

ITA

LVA

USA

EST

PRT

NOR

ISR

0

JPN

0

ESP

5

SVN

5

POL

10

KOR

10

CHL

15

TUR

15

68.4

16

16

LUX

IRL

SVK

LVA

EST

NOR

CHE

DEU

ISR

AUT

SWE

FRA

CAN

CZE

KOR

FIN

PRT

ITA

BEL

SVN

NZL

HUN

NLD

DNK

OECD

ESP

0

GBR

0

POL

4 AUS

4 JPN

8

TUR

8

CHL

12

USA

12

1. 2013 for Canada. 2. International students refer to students who have moved from their country of origin with the purpose of studying. Foreign students refer to students who are not citizens of the countries in which they are enrolled, but may be long-term residents or were born in that country. Source: OECD (2016), Education at a glance 2016: OECD Indicators. 1 2 http://dx.doi.org/10.1787/888933500432

Improving well-being and sustainable development The policy challenge for the authorities is not only to enhance economic growth but also to improve citizens’ well-being and make growth more inclusive and sustainable. Indeed, since the adoption of the 2030 United Nations Agenda for Sustainable Development, the Slovak government, like other OECD countries’, has subscribed to achieving a series of sustainable development goals in a wide range of areas cutting across and complementing the OECD well-being indicators (Slovak Republic, 2016; OECD, 2016e). Achieving these objectives requires a whole-of-government approach. Inter alia this implies focusing on improving outcomes in areas such as education, access to adequate employment and housing, gender equity and the fight against corruption, as mentioned above. Progress is also needed to promote a more efficient health-care system, better health outcomes and improved environmental performance, as discussed below.

A more efficient health-care system would enhance well-being The reduction of the gap in Slovak living standards with the OECD average over the last decade has not been matched by similar progress in health outcomes. Despite substantially increased health-care spending since 2000, health status remains poor in international comparison, even after controlling for differences in per capita income and lifestyle factors

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ASSESSMENT AND RECOMMENDATIONS

(Figure 34). Although health statistics for Roma are often missing, available evidence indicates that large health inequalities exist between the Roma and non-Roma population, with an estimated gap in life expectancy at birth of 10 to 20 years, depending on the degree of integration of the Roma communities, partly reflecting sizable mortality-rate differences among young people (Figure 35, Panel A). Widely perceived mismanagement of public health-care spending is also a source of general discontent (Panel B), as are frequent informal payments, difficulty in accessing out-patient medical services in rural areas and long waiting lists for some elective surgeries.

Figure 34. Health-care spending and outcomes

C. Infant mortality rate³ Deaths per 1000 live births, 2014³

ESP

ISR

GRC

SVN

PRT

OECD²

CHL

CZE

EST

SVK

ESP

OECD²

PRT

60

SVN

0

GRC

65 CHL

2 CZE

70

ISR

4

HUN

75

SVK

6

POL

80

HUN

85

8

EST

B. Life expectancy at birth 2014

POL

A. Total health expenditure¹ 2015

% of GDP 10

D. Amenable mortality4 Deaths per 100 000 inhabitants, 2013

5 ESP PRT SVN EU28 POL CZE EST SVK HUN

4 3 2

SVK

HUN

POL

OECD²

ISR

EST

0

CZE

1

0

50

100

150

200

250

1. 2. 3. 4.

Excludes investment. All data in 2015 are estimated or provisional. Unweighted average. Based on the minimum threshold of 22 weeks of gestation period (or 500 grams birthweight). Three-year average (2012-14). Defined as deaths from selected disease groups that could have been potentially avoided through good quality health care. Data based Eurostat’s list. Source: OECD (2016), OECD Health Statistics (database), Eurostat (2016), Health Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500451

Gains in average life expectancy at birth could be much greater than elsewhere in the OECD if medical spending was as efficient as in the top-ranking countries (Figure 36). Healthy people are more productive and more active, with less absenteeism and longer working lives, resulting in higher lifetime incomes and well-being. Promoting efficiency is also necessary to contain public health-care spending, which will otherwise rise as the population ages (Filko et al., 2012). Improving the health of underprivileged communities also matters because it will help to reduce the high rate of amenable mortality and ultimately boost inclusiveness. However, better health outcomes especially for vulnerable groups, while keeping spending under control, requires reforms in several areas. Aware of this need, after the 2016 elections, the new government has introduced 26 reform projects which aim to address several of the deficiencies of Slovak health care system, as discussed below.

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Figure 35. Health inequalities and perceived mismanagement B. Perception of corruption in the public health-care sector % of respondents agreeing that corruption is widespread among people in the public health-care sector, 2011

A. Roma and non-Roma health status¹ 80

80 Non-Roma

60

60

40

40

20

20

0

Life expectancy

0-14

15-59 60-85 Mortality ( % of age group )

0

FIN LUX BEL DNK SWE IRL NLD GBR DEU FRA ESP AUT PRT EST EU27 CZE ITA POL HUN SVK SVN GRC

Roma

1. Research based on field work in three areas with each Roma community representing 10 to 25% of the total population. Source: European Commission (2012), Special Eurobarometer 374: Corruption (fieldwork September 2011); and B. Gavurová et al. (2014), “Meranie zdravia a zdravotných rizík vo vybraných rómskych osadách na Slovensku – fakty a reflexie”, in Nerovnost’ a chudoba v Európskej únii a na Slovensku, 22-24 October, Košice. 1 2 http://dx.doi.org/10.1787/888933500470

Figure 36. Potential efficiency gains in health care Potential gains in life expectancy1, 2013

Years 7.0

Years 7.0 6.0

5.0

5.0

4.0

4.0

3.0

3.0

2.0

2.0

1.0

1.0

0.0

0.0

JPN ISR CHE KOR ITA FRA ISL ESP SWE LUX NOR CHL MEX AUS TUR GRC CAN NLD OECD NZL PRT AUT EST SVN IRL FIN POL DEU GBR BEL DNK CZE USA HUN SVK

6.0

1. Data envelopment analysis (DEA) was performed with one output (life expectancy at birth) and two inputs (a composite indicator of the socio-economic environment and lifestyle factors and health-care spending). Potential gains are measured if efficiency in a country were to be raised to the level implied by the estimated efficiency frontier while holding inputs constant and under the assumption of non-increasing returns to scale. Source: Dutu, R. and P. Sicari (2016), “Public Spending Efficiency in the OECD: Benchmarking Health Care, Education and General Administration”, OECD Economics Department Working Papers, No. 1278, with updated estimates provided by the authors. 1 2 http://dx.doi.org/10.1787/888933500489

The system of public health insurance has three health insurance companies, including a public health insurer, covering almost two-thirds of the population. Health insurance premiums are fixed by law, and there is no supplementary health-insurance market. This public insurer can legally benefit from the state backing when it suffers losses, according to

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ASSESSMENT AND RECOMMENDATIONS

EC rules, in view of the nature of the Slovak health insurance system, which is based predominantly on the principle of solidarity (EC, 2014b). On the other hand, the state lacks direct control over the entire health-care chain, and management costs are higher than they would be in a single-payer system (Chapter 2). According to available research, there is no single best health-care model, and model selection depends on history and social preferences (OECD, 2010), but the Slovak system would benefit from clarification of the roles of regulated competition and public provision. In this spirit, the new government has defined reform projects to further restrict the profits generated by health insurance companies and distributed to the private shareholders of health insurers as permitted by the Slovak Constitution and EU law, with a view to lower their management costs and improve the transparency in health care. There is a case for rationalising hospital care. The number of acute-care beds per capita is high, and their occupancy rate is low (Figure 37, Panels A and B). Public procurement procedures are deficient and a source of waste (Zachar and Danciková, 2014), so the government has engaged efforts to solve this problem with the introduction of price referencing of medical devices and equipment and centralised procurement for CT scanners. After the 2016 election, the authorities have also prepared measures to modernise the emergency services and reduce the waiting times in hospitals through financing optimisation and better bed management. However, hospitals are still underequipped in terms of advanced technologies (Panels C and D) (Pažitný et al., 2014). Efficiency gains will be achieved if the 2017 introduction of a system of prices for treating diagnostic-related groups

Figure 37. Hospital care A. Number of acute-care beds Per 1000 inhabitants, 2014 or nearest year

0

85

HUN

OECD

POL

90 SVK

1 CZE

95

SVN

2

EST

100

GRC

3

PRT

105

ESP

4

ISR

110

CHL

5

B. Occupancy rate of acute-care beds % of available beds, index 2000=100 Slovak Republic

2000

2002

2004

2006

OECD¹

2008

2010

2012

2014

D. Number of professionally active nurses Number per 1000 inhabitants

C. CT scanners, in hospitals Per million inhabitants, 2014 or nearest year 24

12

20

10

Slovak Republic

16

OECD¹

8

12

PRT

EST

OECD

GRC²

ESP

CZE

2

SVK

0

POL

4 SVN

4 ISR

6

CHL²

8

2000

2002

2004

2006

2008

2010

2012

2014

1. Unweighted average of data of the nearest available year. Source: OECD (2016), OECD Health Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500508

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(DRGs) is transparently implemented, with audits to ensure proper DRG coding and pricing and penalties in case of fraud (Shah et al., 2015). The geographical distribution and specialisation of care in the hospital network also needs to be rationalised, reduced and geographically and functionally optimised, while ongoing efforts to streamline hospital procurement and to cut the number of acute-care beds should be pursued, even more vigorously. Moreover, political appointments of hospital directors should be ended and hospital management further professionalised. Decoupling salaries of medical staff in hospitals, mainly doctors, from average wage in the whole economy and introducing a more flexible system for setting pay, including a variable part related to the hospital performance in order to incentivise staff to adopt new working methods would be beneficial for hospital efficiency. On the other hand, serious consideration should be given to improving nurses’ pay and working conditions, thereby reducing their incentive to emigrate. Improving the efficiency and quality of primary health care is also crucial. Doctors are not evenly distributed between urban and rural districts across the country (Figure 38, Panels A and B). The share of general practitioners (GPs) is low compared to specialists, and many of them are close to retirement (Panels C and D). GPs also face restrictions regarding their competences and prescription-writing authority, which are unusual in OECD countries. Moreover, because their remuneration is essentially based on capitation, they have an incentive to increase the number of enrolled patients, but also to reduce the services

Figure 38. Primary care indicators

5 4

6

3

4

2

2

1

0

0

EST

HUN

ISR

CZE

SVK

SVK³

POL

CZE

0

SVN

0

EST

10 ISR

20 ESP

20

OECD³

40

GRC

30

HUN³

60

PRT³

40

OECD¹

50

80

CHL

D. Share of physicians aged 55-74 2014 or nearest year

CHL

C. Specialists as a share of all doctors² 2014 or nearest year

100

CAN TUR FRA EST KOR JPN PRT HUN AUS SVK OECD¹ CHE BEL FIN SWE CZE NOR GRC

TUR KOR JPN EST CAN BEL AUS FIN CHE FRA SWE OECD¹ HUN PRT SVK NOR CZE GRC

8

SVN

10

B. Rural physician density Per 1000 inhabitants, 2013 or nearest year

ESP

A. Urban physician density Per 1000 inhabitants, 2013 or nearest year

1. Unweighted average. 2. Specialists include paediatricians, obstetricians/gynaecologists, psychiatrists, medical, surgical and other specialists. 3. 2010 for Hungary and 2007 for Slovak Republic. Unweighted average of data for OECD countries for 2014 or nearest year. In Portugal, there is some double-counting of doctors with more than one specialty. Source: OECD (2016), OECD Health Statistics (database); OECD (2015), Health at a Glance 2015: OECD Indicators; and OECD (2013), Health at a Glance 2013: OECD Indicators. 1 2 http://dx.doi.org/10.1787/888933500527

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51

ASSESSMENT AND RECOMMENDATIONS

provided to each of them (OECD, 2016f). Available estimates suggest that almost 80% of consultations result in a referral to a specialist, which is high by international comparison and implies little use of GPs’ gatekeeping function (MoH, 2013; Ringberg et al., 2013). Addressing these difficulties would enhance the quality of primary care, reduce amenable mortality, which is high (Figure 34, Panel D), and save on costs. Some measures have been taken to address these issues. They include the development of the “Residential Programme” since 2014 to increase the attractiveness of being a GP or paediatrician to prevent a decline in their numbers due to retirements. GPs’ skills are also being upgraded, including for the treatment of patients suffering from chronic diseases, such as diabetics. However, the restrictions on GPs’ prescription-writing authority, which are unusually strict, should be lifted. Medical study places for GPs or paediatricians should be increased further and financial incentives introduced to attract them to rural areas (OECD, 2016g). Another reform option to consider is the widening of nurses’ competences and responsibilities to perform some of the basic tasks of the GPs. A better balance between capitation and fee-for-service remuneration would improve patient care. Although some positive steps have been recently made by the government to better specify the payments and co-payments between physicians and patients, the scale of payments for specific services should be reviewed to ensure doctors have the right incentives. Finally, improved co-ordination with specialists in following standard clinical protocols, with closer management of many minor health issues by GPs thanks to a more rapid implementation of electronic personal health records, currently planned for 2021, would be desirable. Efforts to lower pharmaceutical and other health-care spending should continue. Progress has been achieved over the last few decades thanks to the introduction of co-payments, the adoption of a reference-price system and the promotion of generics (Figure 39, Panel A). Nevertheless, pharmaceutical spending remains high (Panel B) and risks being increasingly difficult to control, given the development of costly speciality medicines, demand for which is growing with the rising incidence of chronic diseases. It would be hard to cut prices any further, because Slovak drugs already tend to be re-exported due to their low cost. However, the recent creation of a health technology assessment agency to analyse clinical effectiveness, safety and cost-effectiveness of new devices and drugs is a positive step. Ensuring that e-prescriptions are introduced as planned in the coming year will help avoid overconsumption through better coordination among providers. Consideration should be given to ban all “gifts” from pharmaceutical firms and testing labs to doctors. Research into the causes of the high level of spending on ancillary health services, including lab tests and patient transport, also seems warranted (Panels C and D) (MoF, 2016b). The supply of long-term care is underdeveloped and fragmented (Figure 40, Panel A). Municipalities, which are responsible for the provision of these services, often lack the financial resources to respond adequately to the needs of dependent people, which are very frequently met by informal assistance. Access to long-term care now involves multiple existing channels of aid (health care, social support in cash or in kind), which depend on different bodies, making the system opaque and difficult for users to navigate (Vagac et al., 2014). Creating one-stop shops at the regional level with adequately trained personnel would help people navigate the system and lead to a better allocation of patients to services. Increasing the supply of home care delivered by adequately compensated family members or properly trained professional carers would also help families who currently shoulder most of

52

OECD ECONOMIC SURVEYS: SLOVAK REPUBLIC © OECD 2017

ASSESSMENT AND RECOMMENDATIONS

Figure 39. Pharmaceutical and other medical goods and service spending A. Pharmaceuticals prices Index 2008 = 100

110

Slovak Republic

B. Pharmaceutical spending 2014

% of GDP 2.5

OECD¹

105

2.0

100

1.5

95

GRC

HUN

SVK

ESP

SVN

OECD¹

PRT

POL

2014

2013

2011

2010

OECD¹

2009

2008

2007

2005

2004

2014

2013

2012

2011

0.0

2010

0.0

2009

0.2 2008

0.2 2007

0.4

2006

0.4

2005

0.6

2004

0.6

2003

0.8

2006

Slovak Republic

OECD¹

0.8

2003

Slovak Republic

D. Spending on ancillary services to health care % of GDP 1.0

2012

C. Spending on therapeutic appliances and other medical durables

% of GDP 1.0

CZE

2014

2013

2012

2011

2010

2009

2008

2007

2006

0.0

2005

80

2004

0.5 2003

85

EST

1.0

90

1. Unweighted average of data of the nearest available year. Source: OECD (2016), OECD Health Statistics (database). 1 2 http://dx.doi.org/10.1787/888933500546

Figure 40. Long-term care 2014 or nearest year

A. Long-term care spending % of total current health-care spending 12

25

10

20

8

15

6

10

4

5

2

0

0

GRC AUS PRT HUN USA EST POL LVA SVK¹ ISR ESP SVN FRA CZE OECD² DEU CAN KOR AUT FIN JPN CHE ISL LUX DNK BEL SWE NLD NOR

30

PRT SVK KOR AUT IRL DEU JPN AUS NZL Average³ CHE EST USA LUX ISR SWE NOR

B. Formal long-term care workers Full-time equivalent, % for total population aged 65 years old and over

1. Data from 2013. They include long-term care spending of EUR 344 million by the Slovak Ministry of Labour, Social Affairs and Family. Data for the Slovak Republic include social spending and are not fully comparable with other countries. 2. Unweighted average. 3. Unweighted average of the 12 countries shown in the figure. Source: OECD (2016), OECD Health Statistics (database); Slovak Ministry of Labour, Social Affairs and Family. 1 2 http://dx.doi.org/10.1787/888933500565

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53

ASSESSMENT AND RECOMMENDATIONS

the burden and could save costs as home care can be cheaper than institutionalised care. If not enough carers are forthcoming, the authorities could consider opening this market to immigrants, including from non-EU countries. Finally, promoting healthier lifestyles would also improve health outcomes. Beyond tax measures to reduce consumption of alcohol and sugary beverages mentioned above, actions are needed to promote healthier behaviour among the Roma. Working alongside NGOs, the authorities have called on trained mediators from within the Roma communities to help patients to manage their own health and encourage up-take of vaccinations by accompanying them to the doctor and helping them to understand their prescribed treatments. This is important and welcome, because direct involvement of Roma mediators will help target the needs of the community and increase its sense of empowerment in health and well-being. The authorities should ensure that this programme is adequately resourced. In general, they should seek to involve the Roma community in other initiatives to improve their health outcomes through better water treatment, infrastructure access and housing (Gatti et al., 2016).

Improving environmental outcomes Over the past few decades Slovakia has made good progress in shifting from fossil fuels to renewables in power generation and energy consumption. The country has substantially reduced its greenhouse gas (GHG) emissions and the energy intensity of its economy and also enhanced its air quality (Figure 41). It will fulfil its commitment to the EU 2020 targets of reducing emissions by 20% compared to 1990. For sectors not covered by EU ETS, 2013 emissions had also declined by 24% from 2005, although the national target is for an increase by 13% by 2020. The share of people exposed to the worst level of pollution is lower than the OECD average. Nevertheless, few people escape from a significant degree of air pollution (Figure 41, Panel C), entailing comparatively high mortality risks (Figure 42). The implicit tax rate on energy remains one of the EU’s lowest, and there are several tax exemptions, such as on household electricity consumption, and harmful environmental subsidies to domestic coal production for electricity generation and heating (OECD, 2014a). Making the tax system more environmentally friendly by removing these exemptions and coal subsidies and increasing fees or taxes linked to air pollution would be desirable, both from an economic and publichealth perspective (Table 12). Slovakia should in particular base its car registration fee on vehicles’ emissions as is already done in most EU countries (Acea, 2016). Also, while household waste generation in Slovakia is well below the OECD average, the share that goes to landfill is much higher than average (Figure 41, Panel D), and the rate of recycling is only growing slowly (EC, 2017). A National Waste Act entered into force in January 2016 to bring waste management closer to European norms by shifting the recycling costs to producers and the responsibility for collecting and separating waste to municipalities. The 50% recycling target for 2020 set by the law seems to be overly ambitious, but higher landfill taxes would expedite the adjustment process.

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ASSESSMENT AND RECOMMENDATIONS

Figure 41. Green growth indicators: Slovak Republic B. Energy intensity

A. CO2 intensity CO2 per GDP - production based (kg/USD, 2010 PPP prices) 0.8

CO2 tonnes per capita, demand and production based 14 OECD 12

0.6

Demand Production

10

Slovak Republic

Total primary energy supply per GDP (ktoe/100 USD 2010 PPP) 35 30

Slovak Republic

Demand

8

10 8

Slovak Republic

25

% of renewables in total primary energy supply

OECD

6

20

0.4 6

OECD 0.2

0.0 1990

2013

15

Production

4

10

2

5

0 2000

2011

30 25 20 15

40

OECD

2015

0 1991

Municipal waste 2014 (% of treated) 100 80

15